NPI Profile for DE OMILIA PLASTIC SURGERY PC in BASKING RIDGE, NJ.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery | |
Plastic Surgery |
208200000X | 02 | Physician/General Surgery | |
Surgery of the Hand |
2082S0105X | 02 | Physician/General Surgery |
| NPI # | 1164618435 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/20/2007 | |
| Last updated | 04/03/2008 - About 18 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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