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General NPI Number Information
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NPI Number | 1356546683
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Entity Type | Individual
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Provider Name | RONALD MATTEOTTI MD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 1944 ROUTE 33 SUITE 203
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City | NEPTUNE
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State | NJ
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Zip | 07753-4862
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Country | US
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Telephone | 732-776-4700
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Fax | 732-776-3763
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Provider Business Mailing Address
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Address Line | 1944 ROUTE 33 SUITE 203
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City | NEPTUNE
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State | NJ
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Zip | 07753-4862
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Country | US
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Telephone | 732-776-4700
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Fax | 732-776-3763
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 57.012145
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD436827
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 2086X0206X
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Taxonomy Name | Surgical Oncology Physician
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License Number | 25MA08889100
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License Number State | NJ
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