Provider Demographics
NPI:1588612824
Name:MAROTTA, RAYMOND J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:J
Last Name:MAROTTA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 593
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-0593
Mailing Address - Country:US
Mailing Address - Phone:609-536-8272
Mailing Address - Fax:609-536-8273
Practice Address - Street 1:211 N MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2163
Practice Address - Country:US
Practice Address - Phone:609-536-8272
Practice Address - Fax:609-536-8273
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2014-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA46680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ056185SBVOtherMEDICARE ID TYPE
NJ6203108Medicaid
NJ056185SBVOtherMEDICARE ID TYPE
NJF82264Medicare UPIN