Provider Demographics
NPI:1780779272
Name:HINDERMYER, RONDA M (DPM)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:M
Last Name:HINDERMYER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 HADDON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1449
Mailing Address - Country:US
Mailing Address - Phone:856-833-1479
Mailing Address - Fax:856-854-7969
Practice Address - Street 1:133 CENTERTON RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302
Practice Address - Country:US
Practice Address - Phone:856-453-1551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD002442213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7474601Medicaid
NJ7474601Medicaid
NJ003588Medicare PIN