Individual ProviderJohn FontanettaEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address1 Clara Maass Dr, Clara Maass Medical Center (Emergency Department), Belleville, NJ 07109-3550(973) 450-2100(973) 740-0607PECOS EnrollmentBased on the most recent information from CMS, provider John Fontanetta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 11:47 AM.Profile DetailsProvider ID1457380701Provider TypeIndividualFull NameFontanetta, JohnCredentialMDGenderMaleSole ProprietorNoEnumeration Date6/30/2006Last Updated4/14/2008Contact InformationPractice LocationPractice Address1 Clara Maass Dr, Clara Maass Medical Center (Emergency Department), Belleville, NJ 07109-3550Phone(973) 450-2100FaxUnlisted FaxMailing LocationMailing AddressPO Box 717, Livingston, NJ 07039-0717Phone(973) 740-0607FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense25MA05776900New JerseyProvider IdentifiersIDDescriptionIssuerID7492006DescriptionMedicaidIssuerUnlistedNew Jersey