Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | MC04102 | NJ |
N | 111NR0200X | Radiology | MC04102 | NJ |
N | 213ER0200X | Radiology | MC04102 | NJ |
NPI | 1891846291 |
---|---|
Provider Name | Dr. Ronald Joseph Santangelo |
First Address | Sparta, NJ 07871-2607 |
Second Address | Sparta, NJ 07871-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 21/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223595632 | TAX ID # (01) | NJ |
P1219227 | OXFORD (01) | NJ |