Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MA03368200 | NJ |
NPI | 1023129509 |
---|---|
Provider Name | Mr. Basil John Paparone |
First Address | Pomona, NJ 08240 |
Second Address | Pomona, NJ 08240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1588303 | (05) | NJ |
C53849 | (02) |