Provider Demographics
NPI:1609834522
Name:MAUTI, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:MAUTI
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 1:1020 GALLOPING HILL RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7984
Mailing Address - Country:US
Mailing Address - Phone:908-964-3700
Mailing Address - Fax:908-964-9580
Practice Address - Street 1:1020 GALLOPING HILL RD
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7984
Practice Address - Country:US
Practice Address - Phone:908-964-3700
Practice Address - Fax:908-964-9580
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA32101207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0493858OtherAETNA
NJP809377OtherOXFORD
NJ2947501Medicaid
NJ00741370-00OtherAMERIHEALTH
NJ0K2181OtherHEALTHNET
NJC52763Medicare UPIN
NJ2947501Medicaid