Individual
MARIA BOCCALETTI VISCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2 HEDDEN TERRACE, NORTH ARLINGTON, NJ 07031-6109
(201) 991-5353
(201) 991-0587
Mailing address
85 S JEFFERSON ST, STE. 1, ORANGE, NJ 07050-1562
(973) 677-3466
(973) 677-2362
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA04319400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1788001
—
NJ
01
—
1K9721
HEALTHNET
—
01
—
2594703
GHI
—
01
—
4219773
AETNA
NJ
01
—
MV033S8610
EMPIRE BCBS
NY
01
—
P843368
OXFORD
—
Enumeration date
07/28/2006
Last updated
12/28/2023
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