Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DS036961 | PA |
Y | 213EG0000X | General Practice | DS036961 | PA |
NPI | 1003126392 |
---|---|
Provider Name | Dr. Jerome Michael Rinaldi |
First Address | Bangor, PA 18013-2528 |
Second Address | Bangor, PA 18013-2528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 20/10/2010 |