Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 32717 | MN |
NPI | 1154427763 |
---|---|
Provider Name | Anthony Charles Orecchia |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Saint Paul, MN 55108-5107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 18/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
150593900 | (05) | MN |
AO3129 | (02) |