Individual
DR. PATRICK MONTEFUSCO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 NEW BRUNSWICK AVE, PERTH AMBOY, NJ 08861-3674
(732) 324-5348
Mailing address
PO BOX 48270, NEWARK, NJ 07101-4800
(201) 818-9118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA05255000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4490078
AETNA PPO ID #
NJ
01
—
8219975
GHI PPO ID #
NJ
01
—
P00207311
RAILROAD MEDICARE ID #
NJ
Enumeration date
06/14/2006
Last updated
07/09/2007
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