Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | MD00271500 | NJ |
Y | 222Z00000X | Podiatrist | MD00271500 | NJ |
NPI | 1033181730 |
---|---|
Provider Name | Joseph Signorile |
First Address | Jachson, NJ 07080 |
Second Address | Jackson, NJ 08527-4765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 11/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U85943 | (02) | NY |