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
Phone: (908) 454-9902
Fax: (908) 454-9905
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417915968 | NPPES |
| New Jersey | Other | 0963243 | AETNA |
| New Jersey | MEDICAID | 7437307 | AETNA |
| New Jersey | Other | 223733353 | AETNA |
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