Provider Demographics
NPI:1073623088
Name:BARBELLA, RONALD ANTHONY JR (DPM)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ANTHONY
Last Name:BARBELLA
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:ANTHONY
Other - Last Name:BARBELLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:230 NORTH MAPLE AVENUE
Mailing Address - Street 2:SUITE G2
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2210
Mailing Address - Country:US
Mailing Address - Phone:856-220-6526
Mailing Address - Fax:856-235-3105
Practice Address - Street 1:230 NORTH MAPLE AVENUE
Practice Address - Street 2:SUITE G2
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2210
Practice Address - Country:US
Practice Address - Phone:856-220-6526
Practice Address - Fax:856-235-3105
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00234500213E00000X, 213ES0131X, 213EP1101X
NJ25MD000234500213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0290123000OtherAMERIHEALTH HMO
NJ000708751OtherHIGHMARK
NJ078751MX3Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
NJ000708751OtherHIGHMARK
NJ022540Medicare ID - Type UnspecifiedGROUP NUMBER