Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204E00000X | Oral & Maxillofacial Surgeon | MA0822630 | NJ |
N | 2086S0105X | Surgery of the Hand | MA0822630 | NJ |
N | 2086S0120X | Pediatric Surgery | MA0822630 | NJ |
N | 2086S0122X | Plastic and Reconstructive Surgery | MA0822630 | NJ |
NPI | 1366564460 |
---|---|
Provider Name | Dr. Silvio Podda |
First Address | New York, NY 10010-6711 |
Second Address | Paterson, NJ 07503-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 08/07/2007 |