Provider Demographics
NPI:1538145123
Name:LATTANZI, JOSEPH P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:LATTANZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3600 ROUTE 66 FL 3
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-2645
Mailing Address - Country:US
Mailing Address - Phone:732-807-0877
Mailing Address - Fax:609-978-2843
Practice Address - Street 1:1140 ROUTE 72 W
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2412
Practice Address - Country:US
Practice Address - Phone:609-978-2194
Practice Address - Fax:609-978-2843
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA068736002085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0876999000OtherAMERIHEALTH HMO/POS
NJP2151151OtherOXFORD
NJ1138274OtherHORIZON NJ HEALTH
NJ223444048OtherHIORIZON BCBS
NJ1K6460OtherHEALTHNET
NJ927792OtherAMERIHEALTH PPO
NJ28533OtherUNIVERSITY HEALTH PLAN
NJ223690354OtherHORIZON BCBS
NJ2351598OtherAETNA HMO
NJ2202126OtherAETNA HMO
NJ7576307Medicaid
NJ0876999000OtherAMERIHEALTH HMO/POS
NJ223690354OtherHORIZON BCBS
NJ927792OtherAMERIHEALTH PPO
NJ920005651Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NJ7576307Medicaid
NJ28533OtherUNIVERSITY HEALTH PLAN
NJ025850PB6Medicare ID - Type Unspecified
NJP2151151OtherOXFORD
NJG42868Medicare UPIN