Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00187600 | NJ |
NPI | 1346254638 |
---|---|
Provider Name | Dr. Paul Angelo Latora |
First Address | North Arlington, NJ 07031-6463 |
Second Address | North Arlington, NJ 07031-6463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2006 |
Last Update Date | 30/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1840606 | (05) | NJ |
T87635 | (02) | NJ |