Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 25MA05971000 | NJ |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 25MA05971000 | NJ |
NPI | 1245233634 |
---|---|
Provider Name | Dr. Arnold Criscitiello |
First Address | Ridgewood, NJ 07450-4561 |
Second Address | Ridgewood, NJ 07450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 26/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200040496 | RR MDCR# (01) | NJ |
2448223 | AETNA HMO ID # (01) | NJ |
5973528 | AETNA PPO ID # (01) | NJ |
80P901 | BC/BS OF NY ID # (01) | NJ |
G44615 | (02) | NJ |
P2164406 | OXFORD ID # (01) | NJ |