Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 25MBO2413200 | NJ |
NPI | 1568409159 |
---|---|
Provider Name | Philip William Paparone |
First Address | Galloway, NJ 08205-9406 |
Second Address | Galloway, NJ 08205-9406 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 09/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C52408 | (02) | NJ |