Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 274676 | MA |
NPI | 1255698387 |
---|---|
Provider Name | Eric T Carniol |
First Address | Summit, NJ 07901-3564 |
Second Address | Newark, NJ 07103-2425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 12/07/2019 |