Nils G Herdelin Jr., MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

MA20517 Issued in NJ

Practice address

400 Kings Hwy S
Cherry Hill, NJ 08034-2511

Phone

(856) 428-5488

Fax

(856) 428-6716

NPI assigned

Aug 12, 2005

Sex

Male

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407456000000",
    "number": "1225030877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 KINGS HWY S",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342511",
            "telephone_number": "856-428-5488",
            "fax_number": "856-428-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 KINGS HWY S",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342511",
            "telephone_number": "856-428-5488",
            "fax_number": "856-428-6716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDELIN",
        "first_name": "NILS",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2014-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NJ",
            "license": "MA20517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2708400-2",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Hendricks, NCC,ATR-BC,LPC,LPAT
• Megan E Henninger, PT
• Uriela Henriquez
• Courtney Henson
• Joseph Henson
• Heritage Care
• Brett A Herman, OTR/L
• Lisa Hermanns
• Luxaida J Hernandez-Hierro
• Isabel Alyssa Hernandez

• Otolaryngology Physician in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Otolaryngology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.