Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 25MB10041400 | NJ |
NPI | 1518224153 |
---|---|
Provider Name | Robert Mignone |
First Address | Robbinsville, NJ 08691-4219 |
Second Address | Robbinsville, NJ 08691-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 19/02/2019 |