Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DS019412L | PA |
NPI | 1508804204 |
---|---|
Provider Name | Dr. Ralph A Zampetti |
First Address | Wilkes Barre, PA 18701-1723 |
Second Address | Wilkes Barre, PA 18701-1723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 08/07/2007 |