Robert M Direnzo, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25MA4363600 Issued in NJ

Practice address

2225 E Evesham Rd
Suite 101
Voorhees, NJ 08043-1557

Phone

(856) 795-4330

Fax

(856) 325-3704

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Virtua Medical Group, PA

  • Family Medicine Physician
  • Marlton, NJ
  • NPI 1649226515
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395014400000",
    "number": "1114975679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 ATRIUM WAY",
            "address_2": "SUITE 6",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543917",
            "telephone_number": "856-291-6818",
            "fax_number": "856-291-6819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E EVESHAM RD",
            "address_2": "SUITE 101",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431557",
            "telephone_number": "856-795-4330",
            "fax_number": "856-325-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRENZO",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2014-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA4363600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1481304",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika B Dietzek, APN (NP)
• Justina Dieujuste, MSN, APRN, PMHNP-BC
• Andrea F Digaetano, M.D.
• Anthony Joseph Dilolle, MOT
• Gisele S Dinatale, MA
• Nadishani Thamali Dissanayaka, D.O
• Nicole Ditommaso
• Richard J Dittrich, D.O.
• Bettyann Dusel Divirgilio, APN
• Kelsey Divirgilio, RD

• Family Medicine Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.