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General NPI Number Information
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NPI Number | 1861414294
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Entity Type | Individual
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Provider Name | JOSEPH SAM VETRANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 43 W FRONT ST SUITE 14B
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City | RED BANK
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State | NJ
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Zip | 07701-1624
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Country | US
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Telephone | 732-747-0963
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Fax | 732-747-0963
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Provider Business Mailing Address
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Address Line | 43 W FRONT ST SUITE 14B
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City | RED BANK
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State | NJ
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Zip | 07701-1624
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Country | US
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Telephone | 732-747-0963
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Fax | 732-747-0963
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 25MA02813300
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License Number State | NJ
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