Provider Demographics
NPI:1023055381
Name:DANIEL J. RAGONE, JR, MD, PA
Entity type:Organization
Organization Name:DANIEL J. RAGONE, JR, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:RAGONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:856-222-9713
Mailing Address - Street 1:901 ROUTE 73 N
Mailing Address - Street 2:SUITE B
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053
Mailing Address - Country:US
Mailing Address - Phone:856-222-9713
Mailing Address - Fax:856-222-9714
Practice Address - Street 1:901 ROUTE 73 N
Practice Address - Street 2:SUITE B
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053
Practice Address - Country:US
Practice Address - Phone:856-222-9713
Practice Address - Fax:856-222-9714
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DANIEL J. RAGONE, JR, MD, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-02
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA452052255R0406X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, BlindGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ016277Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER