Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | MC01984 | NJ |
NPI | 1346284932 |
---|---|
Provider Name | Dr. Gene Paterno |
First Address | Hackensack, NJ 07601-2204 |
Second Address | Hackensack, NJ 07601-2204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2007 |