Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS036969 | PA |
NPI | 1063669398 |
---|---|
Provider Name | Dr. Ryan Kenneth Tamburrino |
First Address | Princeton Junction, NJ 08550-1120 |
Second Address | Princeton Junction, NJ 08550-1120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2008 |
Last Update Date | 04/01/2012 |