Provider Demographics
NPI:1295452480
Name:JOHN O'REARDON MD LLC
Entity type:Organization
Organization Name:JOHN O'REARDON MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:O'REARDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-375-2406
Mailing Address - Street 1:2301 E EVESHAM RD STE 304
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4503
Mailing Address - Country:US
Mailing Address - Phone:856-375-2406
Mailing Address - Fax:856-888-1390
Practice Address - Street 1:2301 E EVESHAM RD STE 304
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4503
Practice Address - Country:US
Practice Address - Phone:856-375-2406
Practice Address - Fax:856-888-1390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty