Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00280100 | NJ |
NPI | 1013995182 |
---|---|
Provider Name | Dr. Dariusz Jasinski |
First Address | Lincoln Park, NJ 07035-1104 |
Second Address | Pequannock, NJ 07440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2006 |
Last Update Date | 28/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V01648 | (02) | NJ |