Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | MC00152400 | NJ |
Y | 213ER0200X | Radiology | MC00152400 | NJ |
NPI | 1821246554 |
---|---|
Provider Name | Dr. Frank Dejianne |
First Address | Toms River, NJ 08753-1971 |
Second Address | Toms River, NJ 08753-1971 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2008 |
Last Update Date | 06/09/2008 |