Provider Demographics
NPI:1962578807
Name:ROEHL, BARBARA J (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:J
Last Name:ROEHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1120 DELSEA DR N
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-1444
Mailing Address - Country:US
Mailing Address - Phone:856-853-2055
Mailing Address - Fax:856-848-2879
Practice Address - Street 1:75 W. RED BANK AVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096
Practice Address - Country:US
Practice Address - Phone:856-853-2055
Practice Address - Fax:856-848-2879
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA07519700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0160717Medicaid
NJ123374AWFMedicare PIN