Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 25MA03279700 | NJ |
NPI | 1285660290 |
---|---|
Provider Name | Vicente T. Zapanta |
First Address | Parlin, NJ 08859-1938 |
Second Address | Parlin, NJ 08859-1938 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 16/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CO8996 | (02) | NJ |