Healthcare Provider Details

I. General information

NPI: 1609962240
Provider Name (Legal Business Name): LOUIS F D'AMELIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 01/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 FULD STREET SUITE 303
TRENTON NJ
08638
US

IV. Provider business mailing address

PO BOX 8500-7211
PHILADELPHIA PA
19178-0001
US

V. Phone/Fax

Practice location:
  • Phone: 609-396-2600
  • Fax: 609-396-3600
Mailing address:
  • Phone: 609-396-2600
  • Fax: 609-396-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberMA54893
License Number StateNJ

VIII. Authorized Official

Name: LOUIS D'AMELIO
Title or Position: DIRECTOR
Credential: MD
Phone: 609-396-2600