MEDICARE: DR. THOMAS FELIX SANTUCCI JR. D.O.

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	2080P0214X	Pediatric Pulmonology Physician	25MB03529600	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2082246	OTHER	NJ	FIRST HEALTH
2	3706929	OTHER	NJ	AETNA HMO
3	2K6232	OTHER	NJ	HEALTH NET
4	37272	OTHER	NJ	UNIVERSITY HEALTH PLANS
5	0081671000	OTHER	NJ	AMERIHEALTH HMO/PPO
6	22413	OTHER	NJ	AMERIGROUP
7	P3418603	OTHER	NJ	OXFORD HEALTH PLANS
8	124547	OTHER	NJ	AMERIHEALTH ADMINISTRATOR
9	4466055	OTHER	NJ	AETNA PPO
10	4662536002	OTHER	NJ	CIGNA
11	01000716700	OTHER	NJ	AMERICHOICE
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	60011348	OTHER	NJ	HORIZON NEW JERSEY HEALTH

General Provider Information

NPI Number	:	1568490316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS FELIX SANTUCCI JR. D.O.

Provider Business Mailing Address
First Line	:	1750 ZION RD
Second Line	:	SUITE 107
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1844
Country	:	US
Telephone Number	:	609-677-4566
Fax Number	:	609-677-6080

Provider Business Practice Location Address
First Line	:	1750 ZION RD
Second Line	:	SUITE 107
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-1844
Country	:	US
Telephone Number	:	609-677-4566
Fax Number	:	609-677-6080

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	07/08/2007

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