Provider Demographics
NPI:1831144138
Name:RAIMONDO, RICK A (MD)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:A
Last Name:RAIMONDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4 EVES DR # A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3195
Mailing Address - Country:US
Mailing Address - Phone:609-267-9400
Mailing Address - Fax:609-288-6446
Practice Address - Street 1:401 YOUNG AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3130
Practice Address - Country:US
Practice Address - Phone:609-267-9400
Practice Address - Fax:609-288-6446
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2015-04-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA69344207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0808540000OtherAMERIHEALTH HMO ID
NJ000901220OtherHIGHMARK BLUE SHIELD ID
NJ0808540000OtherAMERIHEALTH HMO ID