Provider Demographics
NPI:1336125574
Name:LARATTA, JOHN A (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:LARATTA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:854 S WHITE HORSE PIKE UNIT 4
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2033
Mailing Address - Country:US
Mailing Address - Phone:609-704-0185
Mailing Address - Fax:609-704-0195
Practice Address - Street 1:854 S WHITE HORSE PIKE UNIT 4
Practice Address - Street 2:
Practice Address - City:HAMMONTON
Practice Address - State:NJ
Practice Address - Zip Code:08037-2033
Practice Address - Country:US
Practice Address - Phone:609-704-0185
Practice Address - Fax:609-704-0195
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB06454100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6996108Medicaid
NJ6996108Medicaid
NJ6996108Medicaid
NJJ9649OtherHORIZON B/C B/S OF NJ
PA0713781001OtherINDEPENDENCE BLUE HMO
NJP403784OtherOXFORD HEALTH PLANS
NJ01000223400OtherAMERICHOICE
PA0713781000OtherINDEPENDENCE BLUE PPO
NJ1K9734OtherHEALTH NET NJ
NJ376482OtherPHCS
NJ0713781001OtherAMERIHEALTH HMO
NJ0713781000OtherAMERIHEALTH PPO