Provider Demographics
NPI:1679543953
Name:POLIZZI, MARIA (MD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:POLIZZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 NEWTONS CORNER RD
Mailing Address - Street 2:RAMTOWN MEDICAL CENTER
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-8818
Mailing Address - Country:US
Mailing Address - Phone:732-458-9760
Mailing Address - Fax:732-458-9762
Practice Address - Street 1:225 NEWTONS CORNER RD
Practice Address - Street 2:RAMTOWN MEDICAL CENTER
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-8818
Practice Address - Country:US
Practice Address - Phone:732-458-9760
Practice Address - Fax:732-458-9762
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA210263207R00000X
NJ25MA08288400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2099063Medicaid
P00394135Medicare PIN
MA2099063Medicaid
MAA38165Medicare PIN