Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 284142 | NY |
NPI | 1043623549 |
---|---|
Provider Name | Alfred Paul Matthew Cellura |
First Address | New York, NY 10013-2442 |
Second Address | Philadelphia, PA 19141-3018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 11/05/2018 |