Healthcare Provider Details
I. General information
NPI: 1154327146
Provider Name (Legal Business Name): DAREN J. AITA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/23/2005
Last Update Date: 03/14/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1225 WHITEHORSE MERCERVILLE RD BLDG. D. SUITE 220
MERCERVILLE NJ
08619-3882
US
IV. Provider business mailing address
833 CHESTNUT ST STE 520
PHILADELPHIA PA
19107-4430
US
V. Phone/Fax
- Phone: 609-581-2200
- Fax: 609-581-1212
- Phone: 800-321-9999
- Fax: 267-479-1321
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | MD061851L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | ME152794 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 25MA06569400 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: