Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MA051464L | PA |
N | 111NI0900X | Internist | MA051464L | PA |
Y | 207R00000X | Internist | MA60953 | NJ |
Y | 111NI0900X | Internist | MA60953 | NJ |
N | 207RA0401X | Internist - Addiction Medicine | ME83954 | FL |
NPI | 1811914476 |
---|---|
Provider Name | Anthony M Musarra |
First Address | Egg Harbor Township, NJ 08234-8421 |
Second Address | Egg Harbor Township, NJ 08234-8421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 06/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F77809 | (02) | NJ |