Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MA050851 | NJ |
NPI | 1154316123 |
---|---|
Provider Name | Dr. Alan Zaccaria |
First Address | Little Silver, NJ 07739-1166 |
Second Address | Little Silver, NJ 07739-1166 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 08/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F52040 | (02) | NJ |