Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 38MC00384000 | NJ |
NPI | 1568524049 |
---|---|
Provider Name | Dr. Aldo R. Scopelliti |
First Address | Long Branch, NJ 07740-6205 |
Second Address | Long Branch, NJ 07740-6205 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 20/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U28120 | (02) | NJ |