Provider Demographics
NPI:1770684169
Name:ADELIZZI, RAYMOND A (DO)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:A
Last Name:ADELIZZI
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 1:215 E LAUREL RD
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08084
Mailing Address - Country:US
Mailing Address - Phone:856-782-9757
Mailing Address - Fax:856-782-9224
Practice Address - Street 1:215 E LAUREL RD
Practice Address - Street 2:ARTHRITIS CENTER OF SOUTH JERSEY
Practice Address - City:STRATFORD
Practice Address - State:NJ
Practice Address - Zip Code:08084
Practice Address - Country:US
Practice Address - Phone:856-782-9757
Practice Address - Fax:856-782-9224
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03419200207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0073810000OtherAMERIHEALTH
NJ2185504Medicaid
0034993OtherAETNA
0034993OtherAETNA
NJ2185504Medicaid