Provider Demographics
NPI:1265784946
Name:MARIA AULETTA MD LLC
Entity type:Organization
Organization Name:MARIA AULETTA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AULETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-243-0088
Mailing Address - Street 1:23 25 S. MAIN ST.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835-1801
Mailing Address - Country:US
Mailing Address - Phone:908-243-0088
Mailing Address - Fax:908-243-0089
Practice Address - Street 1:23 25 S. MAIN ST.
Practice Address - Street 2:SUITE 2
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1801
Practice Address - Country:US
Practice Address - Phone:908-243-0088
Practice Address - Fax:908-243-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04155600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC58779Medicare UPIN