Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MA33985 | NJ |
NPI | 1104977453 |
---|---|
Provider Name | Dr. Roy M Nuzzo |
First Address | Summit, NJ 07901-3533 |
Second Address | Summit, NJ 07901-3533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8023700 | (05) | NJ |
C60675 | (02) | NJ |