Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD024840E | PA |
NPI | 1124137369 |
---|---|
Provider Name | Dr. Joseph M Ardito |
First Address | Wayne, PA 19087-1802 |
Second Address | Paoli, PA 19301-1608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 06/04/2015 |