Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DI01588800 | NJ |
NPI | 1104931401 |
---|---|
Provider Name | Dr. Patricia Marrone |
First Address | Englewood Cliffs, NJ 07632-1831 |
Second Address | Englewood Cliffs, NJ 07632-1831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 29/12/2009 |