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General NPI Number Information
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NPI Number | 1073562872
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Entity Type | Individual
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Provider Name | RALPH DAUITO MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 12/17/2018
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Provider Practice Location Address
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Address Line | 434 NEW JERSEY AVE
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City | ABSECON
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State | NJ
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Zip | 08201-2423
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Country | US
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Telephone | 856-466-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 1690 WHISPERING WOODS WAY
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City | VINELAND
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State | NJ
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Zip | 08361-8602
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Country | US
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Telephone | 856-466-3399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA05144800
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License Number State | NJ
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