Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MA07586700 | NJ |
NPI | 1003843905 |
---|---|
Provider Name | Anthony Altobelli III |
First Address | East Brunswick, NJ 08816-4093 |
Second Address | East Brunswick, NJ 08816-4093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 28/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B99400 | (02) |