Provider Demographics
NPI:1497798581
Name:AULETTA, MARIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:AULETTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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
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
Practice Address - Country:US
Practice Address - Phone:908-243-0088
Practice Address - Fax:908-243-0089
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04155600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0959405Medicaid
NJ0959405Medicaid
NJC58779Medicare UPIN