Provider Demographics
NPI:1538241682
Name:W REED KINDERMANN, M.D. P.A.
Entity type:Organization
Organization Name:W REED KINDERMANN, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:W
Authorized Official - Middle Name:REED
Authorized Official - Last Name:KINDERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-667-3937
Mailing Address - Street 1:3001 CHAPEL AVE W
Mailing Address - Street 2:STE 200
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-1592
Mailing Address - Country:US
Mailing Address - Phone:856-667-3937
Mailing Address - Fax:856-667-0661
Practice Address - Street 1:3001 CHAPEL AVE W
Practice Address - Street 2:SUITE 200
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-1592
Practice Address - Country:US
Practice Address - Phone:856-667-3937
Practice Address - Fax:856-667-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03484500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDG1437OtherRAILROAD MEDICARE
NJ3900703Medicaid
NJDG1437OtherRAILROAD MEDICARE
NJ3900703Medicaid