Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 240704 | NY |
Y | 207YS0123X | Facial Plastic Surgeon | 25MA08409300 | NJ |
NPI | 1710035084 |
---|---|
Provider Name | Dr. Paul Matthew Presti |
First Address | Mountainside, NJ 07092-2316 |
Second Address | Mountainside, NJ 07092-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 26/01/2012 |