Provider Demographics
NPI:1720033426
Name:AMATO, JAMES L JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:AMATO
Suffix:JR
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 1:946 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1308
Mailing Address - Country:US
Mailing Address - Phone:973-743-1121
Mailing Address - Fax:973-743-9419
Practice Address - Street 1:946 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1308
Practice Address - Country:US
Practice Address - Phone:973-743-1121
Practice Address - Fax:973-743-9419
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA061894174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7596308Medicaid
NJG60877Medicare UPIN
NJ003011Medicare PIN