Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0200X | Radiology | MC01802 | NJ |
N | 213ER0200X | Radiology | MC01802 | NJ |
N | 111NX0100X | Occupational Health | MC01802 | NJ |
NPI | 1881613834 |
---|---|
Provider Name | Dr. Ralph J. Dimaio |
First Address | Belleville, NJ 07109-1852 |
Second Address | Belleville, NJ 07109-1852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1181602 | (05) | NJ |
T45592 | (02) | NJ |