Provider Demographics
NPI:1730133158
Name:TINKELMAN, BRAD JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:JAY
Last Name:TINKELMAN
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 1:100 SPRINGDALE RD
Mailing Address - Street 2:SUITE A3 #412
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3300
Mailing Address - Country:US
Mailing Address - Phone:856-616-8777
Mailing Address - Fax:856-616-8780
Practice Address - Street 1:503 WASHINGTON AVE
Practice Address - Street 2:SUITE 2D
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2153
Practice Address - Country:US
Practice Address - Phone:856-616-8777
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA065597002084N0400X
PAMD062295L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10337OtherELDER HEALTH
PATI954659OtherBCBS INDIVIDUAL #
0437018000OtherAMERIHEALTH
3410492OtherAETNA-INDIVIDUAL PROVIDER
3423367OtherAETNA-GROUP #
P61458OtherAMERIHEALTH GROUP #
2255911000OtherKEYSTONE/AMERIHEALTH GRP
PA1561458OtherBCBS-GROUP #
8547249OtherCIGNA GROUP #
P3245151OtherOXFORD GROUP #
3410492OtherAETNA-INDIVIDUAL PROVIDER
2255911000OtherKEYSTONE/AMERIHEALTH GRP
10337OtherELDER HEALTH
NJ080112Medicare ID - Type UnspecifiedGROUP #
PA055653SGPMedicare ID - Type UnspecifiedINDIVIDUAL PROV
P61458OtherAMERIHEALTH GROUP #