Provider Demographics
NPI:1508816661
Name:PONZIO, ROBERT J (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:PONZIO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:P.O. BOX 8863
Mailing Address - Street 2:
Mailing Address - City:TURNERSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8863
Mailing Address - Country:US
Mailing Address - Phone:856-582-7979
Mailing Address - Fax:856-582-8711
Practice Address - Street 1:449 HURFVILLE-CROSSKEYS ROAD
Practice Address - Street 2:SUITE 1
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9369
Practice Address - Country:US
Practice Address - Phone:856-582-7979
Practice Address - Fax:856-582-4259
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB05250100207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF27245Medicare UPIN