Provider Demographics
NPI:1356340780
Name:MONDELLI, JOHN A (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:MONDELLI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8 TEMPE WICK RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1814
Mailing Address - Country:US
Mailing Address - Phone:973-543-2288
Mailing Address - Fax:973-543-0637
Practice Address - Street 1:95 MADISON AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6092
Practice Address - Country:US
Practice Address - Phone:973-898-0400
Practice Address - Fax:973-682-9494
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2018-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07482800207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0023493Medicaid
NJ0023493Medicaid
NJ074599Medicare ID - Type Unspecified