Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00277100 | NJ |
NPI | 1093765059 |
---|---|
Provider Name | Scott Mario Gioioso |
First Address | Rockaway, NJ 07866-1936 |
Second Address | Succasunna, NJ 07876-1345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0047457 | (05) | NJ |
V01357 | (02) | NJ |