Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MA53338 | NJ |
NPI | 1033116801 |
---|---|
Provider Name | Dr. Andrew J Pedinoff |
First Address | Skillman, NJ 08558-2621 |
Second Address | Skillman, NJ 08558-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 02/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03621307 | ECFMG (01) | |
559206 | (05) | NJ |
BP1737595 | DEA (01) | NJ |
D05058100 | CDS (01) | NJ |
E53516 | (02) | NJ |