Provider Demographics
NPI:1518946128
Name:NITTI, JOSEPH T (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:T
Last Name:NITTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 HIGHWAY 70
Mailing Address - Street 2:BLDG. 2B
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-2609
Mailing Address - Country:US
Mailing Address - Phone:732-528-8882
Mailing Address - Fax:732-528-1095
Practice Address - Street 1:2640 HIGHWAY 70
Practice Address - Street 2:BLDG. 2B
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-2609
Practice Address - Country:US
Practice Address - Phone:732-528-8882
Practice Address - Fax:732-528-1095
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03913900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1388207Medicaid
NJDO6714Medicare UPIN
NJ463598Medicare ID - Type Unspecified