Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 25MA05982800 | NJ |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 25MA05982800 | NJ |
N | 207NS0135X | Procedural Dermatology | 25MA05982800 | NJ |
NPI | 1023002664 |
---|---|
Provider Name | Dr. Sabatino Ciatti |
First Address | Westfield, NJ 07090-1687 |
Second Address | Westfield, NJ 07090-1687 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 14/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G63473 | (02) | |
P00433027 | RAILROAD MEDICARE (01) | NJ |