Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0101X | MOHS-Micrographic Surgeon | 25MA07332200 | NJ |
NPI | 1174588321 |
---|---|
Provider Name | Dr. Concettina M Peloro |
First Address | Princeton, NJ 08540-2851 |
Second Address | Monroe Twp, NJ 08831-1864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 14/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223777703 | COMMERCIAL INSURANCES (01) | |
H18329 | (02) | NJ |