Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD436827 | PA |
N | 208600000X | Surgeon | MD436827 | PA |
Y | 2086X0206X | Surgical Oncologist | 25MA08889100 | NJ |
NPI | 1356546683 |
---|---|
Provider Name | Dr. Ronald Matteotti |
First Address | Neptune, NJ 07753-4862 |
Second Address | Neptune, NJ 07753-4862 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 25/07/2016 |