Provider Demographics
NPI:1326125154
Name:MARULLI, RICHARD D
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:MARULLI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 BRIDGE ST
Mailing Address - Street 2:BUILDING E
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2291
Mailing Address - Country:US
Mailing Address - Phone:732-516-0052
Mailing Address - Fax:732-516-0054
Practice Address - Street 1:223 BRIDGE ST
Practice Address - Street 2:BUILDING E
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2291
Practice Address - Country:US
Practice Address - Phone:732-516-0052
Practice Address - Fax:732-516-0054
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI012009001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics