Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 25MA02137400 | NJ |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 25MA02137400 | NJ |
NPI | 1083649032 |
---|---|
Provider Name | Mr. Dante Romei Greco |
First Address | Clifton, NJ 07013-2708 |
Second Address | Clifton, NJ 07013-2708 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 28/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0153508 | (05) | NJ |
D96521 | (02) | |
DO5561 | OXFORD (01) | NJ |
NK1913 | HEALTHNET (01) | NJ |