NPIMap

Organization Active NPI

Rowansom Newjersey Institute for Successful Aging-Geriatric Psychiatry

  • Psychiatry Physician
  • Stratford, NJ
National Provider Identifier
1881668846
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
ROWANSOM NEWJERSEY INSTITUTE FOR SUCCESSFUL AGING-GERIATRIC PSYCHIATRY
Practice address
42 East Laurel Road
Udp, Suite 1800
Stratford, NJ 08084
Phone
(856) 566-6843
Fax
(856) 566-6419
NPI assigned
Feb 15, 2006
Last updated
May 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Michael Rieker
Title
Interim Chief Financial Officier
Phone
(856) 770-5729

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X NU
Psychologist 103T00000X NU
Clinical Social Worker 1041C0700X NU
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

42 East Laurel Road
Udp, Suite 1800
Stratford, NJ 08084

Mailing address

PO Box 635
Bellmawr, NJ 08099-0635
Phone (856) 566-6706

Other identifiers 2

IdentifierTypeStateIssuer
7851006MedicaidNJ
CK3636OtherNJRAILROAD MEDICARE

Other names 1

  • UMDNJ-SOM NewJersey Institute forSuccessful Aging-Geriatric Psychiatry Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 71

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 71

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1881668846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635",
            "city": "BELLMAWR",
            "state": "NJ",
            "postal_code": "080990635",
            "telephone_number": "856-566-6706",
            "fax_number": "856-566-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 EAST LAUREL ROAD",
            "address_2": "UDP, SUITE 1800",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "08084",
            "telephone_number": "856-566-6843",
            "fax_number": "856-566-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROWANSOM NEWJERSEY INSTITUTE FOR SUCCESSFUL AGING-GERIATRIC PSYCHIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "RIEKER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "INTERIM CHIEF FINANCIAL OFFICIER",
        "authorized_official_telephone_number": "856-770-5729"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7851006",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK3636",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMDNJ-SOM NewJersey Institute forSuccessful Aging-Geriatric Psychiatry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.