Provider Demographics
NPI:1891287314
Name:ROWANSOM DEPT OF ENDOCRINOLOGY
Entity Type:Organization
Organization Name:ROWANSOM DEPT OF ENDOCRINOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MANAGED CARE & CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:KELI
Authorized Official - Middle Name:
Authorized Official - Last Name:WORKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-566-6831
Mailing Address - Street 1:42 E LAUREL RD STE 3100
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084-1354
Mailing Address - Country:US
Mailing Address - Phone:856-566-7002
Mailing Address - Fax:
Practice Address - Street 1:42 E LAUREL RD STE 3100
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084-1354
Practice Address - Country:US
Practice Address - Phone:856-566-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROWAN UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty