Provider Demographics
NPI:1144251224
Name:VERDI, MICHELLE (DO)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:VERDI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:WIRTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:40 BEY LEA RD
Mailing Address - Street 2:STE B203
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753
Mailing Address - Country:US
Mailing Address - Phone:732-341-0720
Mailing Address - Fax:732-244-6842
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:STE B203
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-341-0720
Practice Address - Fax:732-244-6842
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB06982700208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
2027196000OtherAMERIHEALTH HMO
10669077OtherCAQH
1334231OtherAMERIHEALTH PPO
2695855OtherGHI
1153465OtherHORIZON NJ HEALTH
2634771OtherAETNA
1162820OtherHORIZON NJ HEALTH
P3320949OtherOXFORD
1162821OtherHORIZON NJ HEALTH