Individual
MICHAEL J RAGUSO-FAILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
279 MATHISTOWN RD, LITTLE EGG HARBOR, NJ 08087
(609) 296-1101
Mailing address
331 NEWMAN SPRINGS RD, BLDG 2, STE 220, RED BANK, NJ 07701-5688
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA07211200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001354216
—
NJ
01
—
223106655
TAX ID
—
Enumeration date
10/19/2006
Last updated
08/26/2024
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