Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 25MB09875400 | NJ |
Y | 208000000X | Pediatrician | 25MB09875400 | NJ |
N | 208000000X | Pediatrician | C20011742 | DE |
N | 208000000X | Pediatrician | OS016839 | PA |
NPI | 1144658337 |
---|---|
Provider Name | William Anthony Emanuele |
First Address | Rockland, DE 19732-0191 |
Second Address | Deptford, NJ 08096-5502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2013 |
Last Update Date | 25/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103258115 | (05) | PA |
1159984-00 | (05) | MD |