Provider Demographics
NPI: | 1093794539 |
---|---|
Name: | TOZZI, JOHN M (MD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | JOHN |
Middle Name: | M |
Last Name: | TOZZI |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2315 ROUTE 34 |
Mailing Address - Street 2: | |
Mailing Address - City: | MANASQUAN |
Mailing Address - State: | NJ |
Mailing Address - Zip Code: | 08736-1444 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 732-974-0404 |
Mailing Address - Fax: | 732-449-4271 |
Practice Address - Street 1: | 2315 ROUTE 34 |
Practice Address - Street 2: | |
Practice Address - City: | MANASQUAN |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08736-1444 |
Practice Address - Country: | US |
Practice Address - Phone: | 732-974-0404 |
Practice Address - Fax: | 732-449-4271 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-01-12 |
Last Update Date: | 2024-12-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NJ | 25MA05212200 | 207X00000X, 207XS0114X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207XS0114X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Adult Reconstructive Orthopaedic Surgery |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NJ | E53471 | Medicare UPIN | |
1017220001 | Medicare NSC | ||
NJ | 512014BC1 | Medicare PIN |