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NPI Code Detail

MEDICARE: DR. ALFREDO G FESTA M.D.

MEDICARE:  DR. ALFREDO G FESTA  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Y00000XOtolaryngology Physician25MA03916500NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013131861
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO G FESTA M.D.
Provider Business Mailing Address
First Line : PO BOX 2475
Second Line :
City : CLIFTON
State : NJ
Zip : 07015-2475
Country : US
Telephone Number : 201-864-3168
Fax Number : 201-864-4488
Provider Business Practice Location Address
First Line : 4508 KENNEDY BLVD
Second Line :
City : UNION CITY
State : NJ
Zip : 07087-2707
Country : US
Telephone Number : 201-864-3168
Fax Number : 201-864-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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