Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 25MD00175800 | NJ |
NPI | 1063574929 |
---|---|
Provider Name | Dr. Paul Michael Palmarozzo |
First Address | Butler, NJ 07405-1407 |
Second Address | Butler, NJ 07405-1407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 07/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1091204 | (05) | NJ |
T45101 | (02) | NJ |