Healthcare Provider Details

I. General information

NPI: 1871784736
Provider Name (Legal Business Name): MAYHILL MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 MARKET STREET
SADDLE BROOK NJ
07663
US

IV. Provider business mailing address

289 MARKET STREET
SADDLE BROOK NJ
07663
US

V. Phone/Fax

Practice location:
  • Phone: 201-368-1744
  • Fax: 201-368-2817
Mailing address:
  • Phone: 201-368-1744
  • Fax: 201-368-2817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD JOSEPH SOLLITTO
Title or Position: MANAGER
Credential: DPM
Phone: 201-368-1744