Provider Demographics
NPI:1639144132
Name:AURORI, KEVIN CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:CHARLES
Last Name:AURORI
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 1:125 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:MAHWAH
Mailing Address - State:NJ
Mailing Address - Zip Code:07430-3212
Mailing Address - Country:US
Mailing Address - Phone:973-809-5078
Mailing Address - Fax:973-538-8307
Practice Address - Street 1:131 MADISON AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7360
Practice Address - Country:US
Practice Address - Phone:973-538-8336
Practice Address - Fax:973-538-8307
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03880000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ022481OtherMEDICARE GROUP NUMBER
NJ513474MWUMedicare ID - Type Unspecified
NJ022481OtherMEDICARE GROUP NUMBER