| Doctor Name: | MR. JOSEPH COLLETTI |
| NPI Number: | 1174946479 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | 25MP00326600 |
| Business Practice Address: | 35 Green Pond Rd Rockaway, NJ - 078662052 |
| Business Phone Number: | 9736255946 |
| Business Fax Number: | 9736253434 |
| Mailing Address: | 35 Green Pond Rd, ROCKAWAY |
| State: | NJ |
| Postal Code: | 078662052 |
| Phone Number: | 9736255946 |
| Fax Number: | 9736253434 |
| NPI Enumeration Date: | 01/23/2014 |
| NPI Last Update Date: | 01/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 25MP00326600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |