Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA27457 | NJ |
NPI | 1013904861 |
---|---|
Provider Name | Dr. Lawrence J Nastro |
First Address | Berkeley Heights, NJ 07922-2104 |
Second Address | Berkeley Heights, NJ 07922-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 18/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C61557 | (02) | NJ |