Aversa, Thaddeus M

Aversa, Thaddeus M is an sole proprietor health care provider with primary practice located at 410 Coventry Centre Dr , Phillipsburg NJ 08865. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Aversa, Thaddeus M can be contacted via phone (908) 454-9902.

Contact Information

Primary practice address
410 Coventry Centre Dr Phillipsburg NJ 08865
Fax: (908) 454-9905
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 25MB065920 New Jersey
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS008958L Pennsylvania
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X OS008958L Pennsylvania

Profile Details

NPI number 1417915968
LBN Legal business name Aversa, Thaddeus M
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2006
Last updated Oct 14th, 2016 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417915968 NPPES
New Jersey Other 0963243 AETNA
New Jersey MEDICAID 7437307 AETNA
New Jersey Other 223733353 AETNA

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