Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22DI01472700 | NJ |
NPI | 1003002635 |
---|---|
Provider Name | Dr. John Anthony Franconeri |
First Address | Bayonne, NJ 07002 |
Second Address | Bayonne, NJ 07002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2007 |
Last Update Date | 18/09/2007 |