Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 25MA05051900 | NJ |
NPI | 1205912144 |
---|---|
Provider Name | Dr. Benjamin George Piantedosi |
First Address | Wenonah, NJ 08090-1141 |
Second Address | Wenonah, NJ 08090-1141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 24/06/2013 |