Valencia, Rafael Lardizabal

Valencia, Rafael Lardizabal is an individual health care provider with primary practice located at 146 Lakeview Dr Suite 102, Gibbsboro NJ 08026. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Valencia, Rafael Lardizabal can be contacted via phone (856) 435-6530.

Contact Information

Primary practice address
146 Lakeview Dr Suite 102 Gibbsboro NJ 08026
Fax: (856) 435-3206
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MA41796 New Jersey

Profile Details

NPI number 1518045525
LBN Legal business name Valencia, Rafael Lardizabal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Jul 8th, 2007 - about 17 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 1518045525 NPPES
New Jersey MEDICAID 3976301

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