Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 024494E | PA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | MA52390 | NJ |
NPI | 1306931233 |
---|---|
Provider Name | Dr. Mario J Arena |
First Address | Haddon Heights, NJ 08035-1299 |
Second Address | Haddon Heights, NJ 08035-1299 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 25/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B40410 | (02) | PA |