Provider Demographics
NPI:1679552921
Name:CONTI, JOSEPH J (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:J
Last Name:CONTI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 LIPPINCOTT DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4112
Mailing Address - Country:US
Mailing Address - Phone:856-782-3300
Mailing Address - Fax:856-504-8029
Practice Address - Street 1:1405 CHEWS LANDING RD
Practice Address - Street 2:SUITE 14
Practice Address - City:LAUREL SPRINGS
Practice Address - State:NJ
Practice Address - Zip Code:08021-2769
Practice Address - Country:US
Practice Address - Phone:856-227-6575
Practice Address - Fax:856-374-9495
Is Sole Proprietor?:No
Enumeration Date:2006-01-14
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB057229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6897606Medicaid
NJF92936Medicare UPIN
NJ6897606Medicaid
NJ552747Medicare PIN