Individual
MARCELLUS A MAIATICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
270 SOUTH BROADWAY, PENNSVILLE, NJ 08070
(856) 678-5449
(856) 678-3153
Mailing address
PO BOX 35, 270 SOUTH BROADWAY, PENNSVILLE, NJ 08070
(856) 678-5449
(856) 678-3153
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
25MA3497600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1695606
—
NJ
Enumeration date
07/16/2006
Last updated
02/14/2010
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