Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 029239 | NY |
NPI | 1639173040 |
---|---|
Provider Name | Dr. Paul Anthony Patella |
First Address | Hartsdale, NY 10530 |
Second Address | Hartsdale, NY 10530 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2005 |
Last Update Date | 08/07/2007 |