Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MA72092 | NJ |
NPI | 1124189030 |
---|---|
Provider Name | Dr. A Peter Salas |
First Address | West Orange, NJ 07052-1122 |
Second Address | West Orange, NJ 07052-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 22/07/2011 |