Provider Demographics
NPI:1821082827
Name:CODEL, RADU (MD)
Entity Type:Individual
Prefix:
First Name:RADU
Middle Name:
Last Name:CODEL
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 1:968 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1221
Mailing Address - Country:US
Mailing Address - Phone:201-969-0994
Mailing Address - Fax:201-969-2453
Practice Address - Street 1:968 RIVER RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1221
Practice Address - Country:US
Practice Address - Phone:201-969-0994
Practice Address - Fax:201-969-2453
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA037721207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3151905Medicaid
NJ448546UX3Medicare PIN
NJC54898Medicare UPIN