Provider Demographics
NPI:1801093737
Name:MASELLA, ROBERT MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:MASELLA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:57 US HIGHWAY 46
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-2695
Mailing Address - Country:US
Mailing Address - Phone:908-813-9700
Mailing Address - Fax:908-813-0033
Practice Address - Street 1:57 US HIGHWAY 46
Practice Address - Street 2:SUITE 107
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2695
Practice Address - Country:US
Practice Address - Phone:908-813-9700
Practice Address - Fax:908-813-0033
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2010-02-01
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA07791000207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6301960001Medicare NSC