Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 25MD00214100 | NJ |
Y | 222Z00000X | Podiatrist | 25MD00214100 | NJ |
NPI | 1043349145 |
---|---|
Provider Name | Linda Cesario |
First Address | Verona, NJ 07044-1630 |
Second Address | Verona, NJ 07044-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U41901 | (02) | NJ |