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General NPI Number Information
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NPI Number | 1639233489
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Entity Type | Organization
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Legal Business Name | JOSEPH J WALLIS & JOSEPH P MAUGERI
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 600 MT PLEASANT AVE SUITE G
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City | DOVER
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State | NJ
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Zip | 07801-1630
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Country | US
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Telephone | 973-989-9000
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Fax | 973-989-8225
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Provider Business Mailing Address
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Address Line | 600 MT PLEASANT AVE SUITE G
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City | DOVER
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State | NJ
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Zip | 07801-1630
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Country | US
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Telephone | 973-989-9000
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Fax | 973-989-8225
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Authorized Official
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Title or Position | PARTNER
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Name | JOSEPH J WALLIS
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Credential | D.O.
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Telephone | 973-989-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MA05912400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 25MB02488400
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License Number State | NJ
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