Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 147994-1 | NY |
NPI | 1023018058 |
---|---|
Provider Name | Edward Alfred Toriello JR. |
First Address | Middle Village, NY 11379-1300 |
Second Address | Middle Village, NY 11379-1300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00885052 | (05) | NY |
C09595 | (02) |