Provider Demographics
NPI:1801074240
Name:RONALD L. BRITTNER DPM
Entity type:Organization
Organization Name:RONALD L. BRITTNER DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRITTNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:856-678-6665
Mailing Address - Street 1:390 N BROADWAY
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:PENNSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08070-1253
Mailing Address - Country:US
Mailing Address - Phone:856-678-6665
Mailing Address - Fax:856-678-7877
Practice Address - Street 1:390 N BROADWAY
Practice Address - Street 2:SUITE 1100
Practice Address - City:PENNSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08070-1253
Practice Address - Country:US
Practice Address - Phone:856-678-6665
Practice Address - Fax:856-678-7877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00094200332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2407906Medicaid
NJ2407906Medicaid
NJ145604Medicare PIN
4798700001Medicare NSC