Basic Information
| Provider Information | |||||||||
| NPI: | 1467505131 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARTNOW | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | JEFFREY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 GROVE ST | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | HADDON HEIGHTS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080351761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8567969200 | ||||||||
| FaxNumber: | 8567969397 | ||||||||
| Practice Location | |||||||||
| Address1: | 231 VAN SCIVER PARKWAY | ||||||||
| Address2: | |||||||||
| City: | WILLINGBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080461132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6098717500 | ||||||||
| FaxNumber: | 6098716026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2007 | ||||||||
| LastUpdateDate: | 06/25/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 25MA02590600 | NJ | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | MD014083E | PA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2085D0003X | 25MA02590600 | NJ | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging | 2085D0003X | MD014083E | PA | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Neuroimaging |
ID Information
| ID | Type | State | Issuer | Description | 0082213000 | 01 | AMERIHEALTH | OTHER | 0573507 | 05 | NJ | MEDICAID | 130008215 | 01 | RAILROAD MEDICARE | OTHER | 80551 | 01 | AMERIGROUP | OTHER | F05770 | 01 | HEALTH NET | OTHER | 0479227002 | 01 | CIGNA | OTHER | 1043873 | 01 | NJ | HORIZON NJ HEALTH | OTHER | 14908 | 01 | UNIVERSITY HEALTH PLAN | OTHER | 0030223 | 01 | AETNA HMO | OTHER | BU000006900 | 01 | NJ | AMERICHOICE | OTHER | 3099884 | 01 | GHI | OTHER | 363582900 | 01 | US DEPT OF LABOR W | OTHER | 000129273 | 01 | NJ | PA BLUE SHIELD | OTHER | 4090958 | 01 | AETNA MANAGED CARE PPO | OTHER | 0082213000 | 01 | KEYSTONE HPE | OTHER | 1399566 | 01 | UNITED HEALTHCARE | OTHER | BNS141 | 01 | OXFORD | OTHER |