Ietta, Michael Angelo
Ietta, Michael Angelo is an individual health care provider with primary practice located at 500 W Main St Suite 16, Wyckoff NJ 07481-1439. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Ietta, Michael Angelo can be contacted via phone (201) 847-9403.Contact Information
Primary practice address
500 W Main St Suite 16
Wyckoff NJ 07481-1439
Phone: (201) 847-9403
Fax: (201) 847-0059
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MA56733 | New Jersey |
Profile Details
| NPI number | 1356319735 |
|---|---|
| LBN Legal business name | Ietta, Michael Angelo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 10th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356319735 | NPPES |
| New Jersey | MEDICAID | 5508207 |
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