MEDICARE: MICHAEL ANTHONY ACOCELLA DO

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	MB58946	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	:	1770575037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ANTHONY ACOCELLA DO

Provider Business Mailing Address
First Line	:	138 WESTFIELD AVE
Second Line	:	STE 5
City	:	CLARK
State	:	NJ
Zip	:	07066-2454
Country	:	US
Telephone Number	:	732-381-5565
Fax Number	:	732-381-5222

Provider Business Practice Location Address
First Line	:	138 WESTFIELD AVE
Second Line	:	STE 5
City	:	CLARK
State	:	NJ
Zip	:	07066-2454
Country	:	US
Telephone Number	:	732-381-5565
Fax Number	:	732-381-5222

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	01/25/2011

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