Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 2MA02669600 | NJ |
NPI | 1235360892 |
---|---|
Provider Name | Dr. Panfilo G Canton |
First Address | Freehold, NJ 07728-2766 |
Second Address | Freehold, NJ 07728-2766 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2009 |
Last Update Date | 03/08/2009 |