Provider Demographics
NPI:1568490316
Name:SANTUCCI, THOMAS FELIX JR (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FELIX
Last Name:SANTUCCI
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1750 ZION RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1844
Mailing Address - Country:US
Mailing Address - Phone:609-677-4566
Mailing Address - Fax:609-677-6080
Practice Address - Street 1:1750 ZION RD
Practice Address - Street 2:SUITE 107
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1844
Practice Address - Country:US
Practice Address - Phone:609-677-4566
Practice Address - Fax:609-677-6080
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB035296002080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2082246OtherFIRST HEALTH
NJ3706929OtherAETNA HMO
NJ2K6232OtherHEALTH NET
NJ37272OtherUNIVERSITY HEALTH PLANS
NJ0081671000OtherAMERIHEALTH HMO/PPO
NJ22413OtherAMERIGROUP
NJP3418603OtherOXFORD HEALTH PLANS
NJ124547OtherAMERIHEALTH ADMINISTRATOR
NJ4466055OtherAETNA PPO
NJ4662536002OtherCIGNA
NJ01000716700OtherAMERICHOICE
NJ2184206Medicaid
NJ60011348OtherHORIZON NEW JERSEY HEALTH
NJ2184206Medicaid