Provider Demographics
NPI:1801239918
Name:NEITZEL, KRISTI MARIE (MD)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:MARIE
Last Name:NEITZEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:MARIE
Other - Last Name:SHIMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15000 MIDLANTIC DRIVE #102
Mailing Address - Street 2:RANCOCAS ANESTHESIOLOGY
Mailing Address - City:MT. LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054
Mailing Address - Country:US
Mailing Address - Phone:856-829-9345
Mailing Address - Fax:
Practice Address - Street 1:18 E LAUREL RD
Practice Address - Street 2:JEFFERSON STRATFORD HOSPITAL
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084
Practice Address - Country:US
Practice Address - Phone:856-346-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10059100207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology