Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 25MB07820800 | NJ |
NPI | 1235338872 |
---|---|
Provider Name | Dr. Anthony Charles Corrado |
First Address | Cherry Hill, NJ 08003-1115 |
Second Address | Cherry Hill, NJ 08003-1115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2007 |
Last Update Date | 06/03/2017 |