Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | MD001947 | NJ |
N | 222Z00000X | Podiatrist | MD001947 | NJ |
N | 213E00000X | Podiatrist | N004666 | NY |
N | 222Z00000X | Podiatrist | N004666 | NY |
N | 2081S0010X | Sports Medicine | MD001947 | NJ |
N | 213ES0000X | Sports Medicine | MD001947 | NJ |
Y | 213ES0103X | Foot & Ankle Surgery | MD001947 | NJ |
N | 213ES0131X | Foot Surgery | MD001947 | NJ |
NPI | 1275502304 |
---|---|
Provider Name | Dr. Thomas J. Azzolini |
First Address | Hoboken, NJ 07030-2370 |
Second Address | Hoboken, NJ 07030-2370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1499718 | GHI (01) | NJ |
1K9793 | HEALTHNET (01) | NJ |
446076 | CIGNA (01) | NJ |
5056900 | (05) | NJ |
P2094195 | OXFORD (01) | NJ |
U22812 | (02) | NJ |