Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 2990 | NJ |
NPI | 1164433355 |
---|---|
Provider Name | Dr. Blase J Toto |
First Address | East Brunswick, NJ 08816-3607 |
Second Address | East Brunswick, NJ 08816-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T45722 | (02) | NJ |