Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 25MA05783500 | NJ |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 25MA05783500 | NJ |
NPI | 1083667380 |
---|---|
Provider Name | Dr. Steven D Datorre |
First Address | Haddon Heights, NJ 08035-1715 |
Second Address | Haddon Heights, NJ 08035-1715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 06/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7430108 | (05) | NJ |
E81819 | (02) | NJ |