Louis John Ciravolo, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

MD02339 Issued in NJ

Practice address

602 S Broadway
Camden, NJ 08103-1222

Phone

(856) 963-2266

Fax

(856) 772-2881

NPI assigned

Jan 5, 2007

Last updated

Jul 9, 2007By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1780731034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 OAKLYN CT",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080431817",
            "telephone_number": "856-772-2885",
            "fax_number": "856-772-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 S BROADWAY",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031222",
            "telephone_number": "856-963-2266",
            "fax_number": "856-772-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIRAVOLO",
        "first_name": "LOUIS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "MD02339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7279302",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICHOICE OF NJ",
            "identifier": "010002883-00",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON NJ HEALTH",
            "identifier": "1107086",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Churlin, MD
• Noelle Ciara, LSW
• Peter Cichon
• Sabrina Ciervo
• Donald R Cioffi, D.C.
• Cristian Cirjan, MD
• City Eyes ,LLC (City Eyes Optical)
• City Invincible Charter School
• Gabriella Renee Ciullo
• Ryan Clardy, DPT

• Primary Podiatric Medicine Podiatrist in Camden, NJ
• Providers in Camden, NJ by specialty
• Primary Podiatric Medicine Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.