Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 25MA03241800 | NJ |
Y | 208600000X | Surgeon | 25MA03241800 | NJ |
NPI | 1013973650 |
---|---|
Provider Name | Dr. Theodora J Maio |
First Address | Clifton, NJ 07013-4019 |
Second Address | Clifton, NJ 07013-4019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2006 |
Last Update Date | 08/07/2007 |