Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 25MD00274900 | NJ |
N | 222Z00000X | Podiatrist | 25MD00274900 | NJ |
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00274900 | NJ |
NPI | 1013989789 |
---|---|
Provider Name | Dr. Marco Ucciferri |
First Address | New Providence, NJ 07974-1557 |
Second Address | Manville, NJ 08835-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 15/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U95862 | (02) | NJ |