Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | MA41196 | NJ |
NPI | 1811151269 |
---|---|
Provider Name | Dr. Joseph Durso Coffineau |
First Address | Galloway, NJ 08205-9628 |
Second Address | Galloway, NJ 08205-9628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 15/07/2008 |