MEDICARE: DR. SALVATORE FOCELLA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MA60707	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013901511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SALVATORE FOCELLA M.D.

Provider Business Mailing Address
First Line	:	1 W RIDGEWOOD AVE
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-2359
Country	:	US
Telephone Number	:	201-444-5807
Fax Number	:	201-447-9338

Provider Business Practice Location Address
First Line	:	1 W RIDGEWOOD AVE
Second Line	:
City	:	PARAMUS
State	:	NJ
Zip	:	07652-2359
Country	:	US
Telephone Number	:	201-444-5807
Fax Number	:	201-447-9338

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	10/01/2013

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