Provider Demographics
NPI:1609957026
Name:VINER, EDWARD D (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:D
Last Name:VINER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FEDERAL ST
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:856-968-8499
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 215
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-2439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49832207R00000X, 207RH0003X
PAMD006257E207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
84180OtherAMERICAID
0409679000OtherAMERIHELATH, HMO, KEYSTONE, IBC
1241993OtherUNITED HEALTH CARE
8668474OtherCIGNA
1090701OtherHORIZON NJ HEALTH
587776OtherAMERIHEALTH PPO
3K5932OtherHEALTHNET
010003733 00OtherAMERICHOICE
014707OtherPA MEDICARE
123457OtherAETNA
15133OtherUNIVERSITY HEALTH
0655708OtherOXFORD HEALTH PLAN
B32336Medicare UPIN
587776Medicare PIN
014707OtherPA MEDICARE