Provider Demographics
NPI:1841235991
Name:CALON, MARITONI JESUSA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARITONI
Middle Name:JESUSA
Last Name:CALON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARITONI
Other - Middle Name:JESUSA
Other - Last Name:CALON-SHAH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:8 ALFALFA CIR
Mailing Address - Street 2:
Mailing Address - City:PLAINSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08536-3141
Mailing Address - Country:US
Mailing Address - Phone:609-275-0129
Mailing Address - Fax:
Practice Address - Street 1:300B PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:SUITE #201
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1411
Practice Address - Country:US
Practice Address - Phone:609-448-7300
Practice Address - Fax:609-448-8022
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 072698207RA0000X
NJMA0726982080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH78263Medicare UPIN