Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 058602 | NY |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 280315 | NY |
NPI | 1053638387 |
---|---|
Provider Name | Dr. Drew A Nunziata |
First Address | Suffern, NY 10901 |
Second Address | Suffern, NY 10901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2010 |
Last Update Date | 27/07/2016 |