Provider Demographics
NPI:1700077625
Name:GERMAINE, PAULINE (DO)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:
Last Name:GERMAINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER UNIVERISTY RADIOLOGY
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-2382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB0818822085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2837091OtherUNITED HEALTHCARE
NJP00451437OtherRR MEDICARE
NJ01004839502OtherAMERICHOICE
NJ5024810OtherCIGNA
NJ60033588OtherHORIZON NJ HEALTH
NJP3831301OtherOXFORD
NJ1614371OtherAETNA
NJ0143341Medicaid
NJ3422387000OtherAMERIHEALTH/KEYSTONE/IBC
NJ117436 SF5Medicare PIN