Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00129400 | NJ |
NPI | 1053316885 |
---|---|
Provider Name | Dr. Christian Anthony Robertozzi |
First Address | Newton, NJ 07860-9612 |
Second Address | Newton, NJ 07860-9612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1874004 | (05) | NJ |
T44889 | (02) | NJ |