Basic Information
| Provider Information | |||||||||
| NPI: | 1255344594 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ARTHRITIS & RHEUMATOLOGY ASSOCIATES OF SOUTH JERSEY PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 2697 | ||||||||
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| City: | VINELAND | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 083622697 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567949090 | ||||||||
| FaxNumber: | 8567945658 | ||||||||
| Practice Location | |||||||||
| Address1: | 2848 S DELSEA DR | ||||||||
| Address2: | SUITE 2C | ||||||||
| City: | VINELAND | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567949090 | ||||||||
| FaxNumber: | 8567945658 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2006 | ||||||||
| LastUpdateDate: | 08/03/2011 | ||||||||
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| AuthorizedOfficialLastName: | SOLOWAY | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8567949090 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 25MA05934500 | NJ | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 0107328 | 05 | NJ | MEDICAID |