Provider Demographics
NPI:1316007743
Name:NAPOLITANO, MASSIMO MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:MASSIMO
Middle Name:MARK
Last Name:NAPOLITANO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:211 ESSEX STREET
Mailing Address - Street 2:SUITE102
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601
Mailing Address - Country:US
Mailing Address - Phone:201-487-8882
Mailing Address - Fax:201-487-0943
Practice Address - Street 1:211 ESSEX STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601
Practice Address - Country:US
Practice Address - Phone:201-487-8882
Practice Address - Fax:201-487-0943
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2012-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA598952086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6209009Medicaid
NJ6209009Medicaid
161877Medicare ID - Type Unspecified