Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB07663200 | NJ |
N | 207QS0010X | Family Doctor - Sports Medicine | 25MB07663200 | NJ |
N | 2081S0010X | Sports Medicine | 25MB07663200 | NJ |
N | 213ES0000X | Sports Medicine | 25MB07663200 | NJ |
NPI | 1558459487 |
---|---|
Provider Name | Dr. Albert Joseph Pogorelec JR. |
First Address | Clifton, NJ 07012-1400 |
Second Address | Clifton, NJ 07012-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |