Basic Information
| Provider Information | |||||||||
| NPI: | 1669676219 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | D'ANTUONO | ||||||||
| FirstName: | JUSTIN | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 191 | ||||||||
| Address2: | |||||||||
| City: | ROCKLAND | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197230191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3026514000 | ||||||||
| FaxNumber: | 3026514945 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 PEOPLES PLAZA, SUITE 300 | ||||||||
| Address2: | |||||||||
| City: | NEWARK | ||||||||
| State: | DE | ||||||||
| PostalCode: | 197025708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3028367820 | ||||||||
| FaxNumber: | 3028367826 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 10/11/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | C7-0003828 | DE | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MT190804 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208D00000X | C10009440 | DE | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.