Provider Demographics
NPI:1457545337
Name:DENNIS T.NATOLI M.D.P.A.
Entity Type:Organization
Organization Name:DENNIS T.NATOLI M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:THEODORE
Authorized Official - Last Name:NATOLI
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:201-487-1656
Mailing Address - Street 1:325 KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1826
Mailing Address - Country:US
Mailing Address - Phone:201-487-1656
Mailing Address - Fax:201-487-8650
Practice Address - Street 1:325 KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1826
Practice Address - Country:US
Practice Address - Phone:201-487-1656
Practice Address - Fax:201-487-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA020515261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJB12128Medicare UPIN