Provider Demographics
NPI:1437259124
Name:HEINTZ, KATHLEEN M (DO)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:HEINTZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 COOPER PLZ
Mailing Address - Street 2:KELEMAN 404
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1461
Mailing Address - Country:US
Mailing Address - Phone:856-342-2034
Mailing Address - Fax:856-342-6608
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 311
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-2034
Practice Address - Fax:856-342-6608
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB61322207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
010003878 00OtherAMERICHOICE
060060586OtherRAIL ROAD MEDICARE
10658339OtherCAQH
3K5960OtherHEALTHNET
PI863791OtherOXFORD HEALTH PLAN
2230568OtherAETNA US-HEALTHCARE
NJ7965109Medicaid
0347034000OtherAMERIHEALTH, HMO, KEYSTONE, IBC
1953539OtherUNITED HEALTH CARE
572159OtherAMERIHEALTH PPO
8352825OtherCIGNA
24646OtherUNIVERSITY HEALTH CARE
1103307OtherHORIZON NJ HEALTH
3K5960OtherHEALTHNET
2230568OtherAETNA US-HEALTHCARE