Basic Information
Provider Information
NPI: 1164514642
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: APUZZIO
FirstName: JOSEPH
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 30 BERGEN ST
Address2: ADMC 12 1205
City: NEWARK
State: NJ
PostalCode: 071073000
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 140 BERGEN ST
Address2: ACC LEVEL C
City: NEWARK
State: NJ
PostalCode: 071032425
CountryCode: US
TelephoneNumber: 9739722700
FaxNumber: 9739722739
Other Information
ProviderEnumerationDate: 09/29/2006
LastUpdateDate: 07/22/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VM0101X25MA02884400NJY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine

ID Information
IDTypeStateIssuerDescription
141840805NJ MEDICAID


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