Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 038 607 | NY |
NPI | 1073647772 |
---|---|
Provider Name | Dr. Pasquale J Malpeso |
First Address | New York, NY 10021-7314 |
Second Address | New York, NY 10021-7314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U29688 | (02) | NY |