Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA056530 | NJ |
NPI | 1033292867 |
---|---|
Provider Name | Dr. Mary Jo Paradiso |
First Address | Edison, NJ 08820-3946 |
Second Address | Edison, NJ 08820-3946 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G08901 | (02) | NJ |