Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 25MA10296500 | NJ |
N | 204F00000X | Transplant Surgeon | 35058355 | OH |
NPI | 1770538258 |
---|---|
Provider Name | Dr. Ronald P. Pelletier |
First Address | New Brunswick, NJ 08901-2066 |
Second Address | New Brunswick, NJ 08901-2066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 31/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0249645 | (05) | OH |
G26976 | (02) |