Provider Demographics
NPI:1679669618
Name:ZECHOWY, RACINE B (MD)
Entity Type:Individual
Prefix:DR
First Name:RACINE
Middle Name:B
Last Name:ZECHOWY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 GROVE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HADDON HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1761
Mailing Address - Country:US
Mailing Address - Phone:856-796-9207
Mailing Address - Fax:856-796-9397
Practice Address - Street 1:127 CHURCH RD STE 800
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9425
Practice Address - Country:US
Practice Address - Phone:856-988-7899
Practice Address - Fax:856-988-9499
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06423600208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7464002Medicaid
NJ557517C04Medicare PIN
G81100Medicare UPIN