Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 046984 | NY |
NPI | 1043640709 |
---|---|
Provider Name | Dr. Christopher Paladino |
First Address | Massapequa, NY 11758-5006 |
Second Address | Massapequa, NY 11758-5006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2013 |
Last Update Date | 17/11/2013 |