Provider Demographics
NPI:1366413056
Name:ROMANELLA, JOSEPH P (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:ROMANELLA
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 1:195 ROUTE 9 S
Mailing Address - Street 2:STE 108
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-536-7144
Mailing Address - Fax:732-536-7520
Practice Address - Street 1:195 ROUTE 9 S
Practice Address - Street 2:STE 108
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-536-7144
Practice Address - Fax:732-536-7520
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB59608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMB59608Medicare UPIN
778203NTUMedicare ID - Type Unspecified