Provider Demographics
NPI:1811034564
Name:RITA R KAMMIEL MD
Entity Type:Organization
Organization Name:RITA R KAMMIEL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CAMPISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-383-3330
Mailing Address - Street 1:707 WHITE HORSE PIKE
Mailing Address - Street 2:SUITE A3
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-1458
Mailing Address - Country:US
Mailing Address - Phone:609-383-3330
Mailing Address - Fax:609-383-3301
Practice Address - Street 1:707 WHITE HORSE PIKE
Practice Address - Street 2:SUITE A3
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-1458
Practice Address - Country:US
Practice Address - Phone:609-383-3330
Practice Address - Fax:609-383-3301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA431512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ904269Medicare ID - Type Unspecified