Provider Demographics
NPI:1982613113
Name:REGIONAL NEPHROLOGY ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:REGIONAL NEPHROLOGY ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHREYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-383-0200
Mailing Address - Street 1:510 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225
Mailing Address - Country:US
Mailing Address - Phone:609-383-0200
Mailing Address - Fax:609-383-8352
Practice Address - Street 1:510 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225
Practice Address - Country:US
Practice Address - Phone:609-383-0200
Practice Address - Fax:609-383-8352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CF1734OtherRR MDCR
NJ184833Medicare PIN