Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 25MA03741200 | NJ |
NPI | 1326266644 |
---|---|
Provider Name | Dr. Nunzio Richard Stella |
First Address | Toms River, NJ 08753-1600 |
Second Address | Toms River, NJ 08753-1600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2983800 | (05) | NJ |
C52961 | (02) | NJ |