Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 25MA07581500 | NJ |
NPI | 1265409205 |
---|---|
Provider Name | Dr. James C. Natalicchio |
First Address | Hackensack, NJ 07601-1960 |
Second Address | Hackensack, NJ 07601-1960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H68778 | (02) | NJ |