Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 091858-1 | NY |
NPI | 1235302001 |
---|---|
Provider Name | Sergio Piomelli |
First Address | Englewood, NJ 07631-5104 |
Second Address | Englewood, NJ 07631-5104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 11/04/2008 |