Provider Demographics
NPI:1265519383
Name:AMOROSA, LOUIS (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:
Last Name:AMOROSA
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:125 PATERSON ST
Practice Address - Street 2:CLINICAL ACADEMIC BUILDING - SUITE 5100A
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1962
Practice Address - Country:US
Practice Address - Phone:732-235-7219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03011300207R00000X, 207RE0101X
NJMA30113207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1124803Medicaid
NJ460000545OtherRR MCR PTAN
NJ460000545OtherRR MCR PTAN
NJ507548A3YMedicare PIN