Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22DI02835000 | NJ |
NPI | 1033646765 |
---|---|
Provider Name | Dr. Luke Joseph Zambetti |
First Address | Montclair, NJ 07042-4376 |
Second Address | Caldwell, NJ 07006-5012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2017 |
Last Update Date | 06/07/2021 |