Provider Demographics
NPI:1770671075
Name:BARALDI, RAYMOND L JR (MD)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:L
Last Name:BARALDI
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 1:1 COOPER PLZ
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1461
Mailing Address - Country:US
Mailing Address - Phone:856-342-2380
Mailing Address - Fax:856-365-0472
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERISTY RADIOLOGY
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2382
Practice Address - Fax:856-365-0472
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0764362085R0202X
PAMD019361E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0065706Medicaid
NJ2627365000OtherAMERIHEALTH/KEYSTONE/IBC
NJ37896OtherUNIVERSITY HEALTH PLAN
NJP00200058OtherRR MEDICARE
NJ01000764700OtherAMERICHOICE
NJ1789950OtherAMERIHEALTH PPO/PA BS
NJ4828558OtherCIGNA
NJ1260885OtherUNITED HEALTHCARE
NJP3737594OtherOXFORD
NJ3983293OtherAETNA
NJ60019065OtherHORIZON NJ HEALTH
NJ4828558OtherCIGNA
NJ0065706Medicaid