Niedbala, Thomas M

Niedbala, Thomas M is an individual health care provider with primary practice located at 100 Carnie Blvd Suite B-5, Voorhees NJ 08043-4512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Niedbala, Thomas M can be contacted via phone (856) 751-0123.

Contact Information

Primary practice address
100 Carnie Blvd Suite B-5 Voorhees NJ 08043-4512
Fax: (856) 751-0535
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 25MA05934400 New Jersey

Profile Details

NPI number 1851390223
LBN Legal business name Niedbala, Thomas M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated May 31st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851390223 NPPES
New Jersey MEDICAID 4603401
New Jersey Other A3738029
New Jersey Other NI747400
New Jersey Other 1388808
New Jersey Other 0656838000
New Jersey Other 300069412
New Jersey Other 0733044
New Jersey Other 1089830
New Jersey Other NI747400

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