Provider Demographics
NPI:1245297399
Name:RANELLE, ROBERT G (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:RANELLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 ROUTE 70 W
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-3524
Mailing Address - Country:US
Mailing Address - Phone:856-616-2999
Mailing Address - Fax:856-616-1439
Practice Address - Street 1:455 ROUTE 70 W
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-3524
Practice Address - Country:US
Practice Address - Phone:856-616-2999
Practice Address - Fax:856-616-1439
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS005285L207X00000X
TXH3598207X00000X
NJ25MB07902600207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ312597Medicare PIN