Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MA05576800 | NJ |
NPI | 1447272927 |
---|---|
Provider Name | Joseph L Maccarone |
First Address | Mount Laurel, NJ 08054-3917 |
Second Address | Voorhees, NJ 08043-9623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 21/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5591805 | (05) | NJ |
E60010 | (02) |