Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MA63710 | NJ |
NPI | 1821060187 |
---|---|
Provider Name | Dr. Victor Gerard Gentile |
First Address | Hackettstown, NJ 07840-4174 |
Second Address | Hackettstown, NJ 07840-4174 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 24/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G28190 | (02) | NJ |