Provider Demographics
NPI:1922045194
Name:RAGONE, DANIEL J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:RAGONE
Suffix:JR
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 1:901 ROUTE 73 N STE B
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2034
Mailing Address - Country:US
Mailing Address - Phone:856-222-9713
Mailing Address - Fax:856-222-9714
Practice Address - Street 1:901 ROUTE 73 N STE B
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2034
Practice Address - Country:US
Practice Address - Phone:856-222-9713
Practice Address - Fax:856-222-9714
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA45205208100000X
NJ25MA04520500208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
1023055381OtherNPPES
NJ1748203Medicaid
NJE39118Medicare UPIN