Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 25MA02428400 | NJ |
NPI | 1013165554 |
---|---|
Provider Name | Dr. George Michael Arcieri |
First Address | Ridgewood, NJ 07450-2604 |
Second Address | Ridgewood, NJ 07450-2604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 08/09/2008 |