Provider Demographics
NPI:1861498693
Name:MORELOS, JOSEPH C (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:MORELOS
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 1:1215 ROUTE 70 WEST
Mailing Address - Street 2:SUITE 1005
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-942-0888
Mailing Address - Fax:732-942-1230
Practice Address - Street 1:1215 ROUTE 70 WEST
Practice Address - Street 2:SUITE 1005
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701
Practice Address - Country:US
Practice Address - Phone:732-942-0888
Practice Address - Fax:732-942-1230
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB72980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8685606Medicaid
NJH42463Medicare UPIN
NJ8685606Medicaid