Organization
NORTH HALEDON MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY J BARRAVECCHIO DO (OWNER)
(973) 427-6975
Entity
Organization
Contact information
Practice address
535 HIGH MOUNTAIN RD, SUITE 202, NORTH HALEDON, NJ 07508-2665
(973) 427-6975
Mailing address
535 HIGH MOUNTAIN RD, SUITE 202, NORTH HALEDON, NJ 07508-2665
(973) 427-6975
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MB06978600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2016613000
AMERITHEALTH GROUP #
NJ
01
—
DC3972
RAILROAD MEDICARE GROUP #
NJ
Enumeration date
06/02/2006
Last updated
04/04/2013
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