1730512443 NPI number — RAPHA MEDICAL GROUP PC

Table of content: MRS. MELISSA MARIE BARTOLOTTA APRN (NPI 1376301713)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730512443 NPI number — RAPHA MEDICAL GROUP PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAPHA MEDICAL GROUP PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730512443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4622 BLACK HORSE PIKE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
MAYS LANDING
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-705-8143
Provider Business Mailing Address Fax Number:
609-837-0144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4622 BLACK HORSE PIKE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
MAYS LANDING
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-705-8143
Provider Business Practice Location Address Fax Number:
609-837-0144
Provider Enumeration Date:
08/16/2013

Additional Information

Authorized Official

Authorized Official Last Name:
UNUIGBE
Authorized Official First Name:
AUGUSTINE
Authorized Official Middle Name:
AIGBOVBIOISE
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
609-457-1415

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com