Healthcare Provider Details
I. General information
NPI: 1538279658
Provider Name (Legal Business Name): ANGELO DEL PRIORE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 KINGS RD
MADISON NJ
07940
US
IV. Provider business mailing address
290 MADISON AVE STE 3A
MORRISTOWN NJ
07960-7401
US
V. Phone/Fax
- Phone: 973-822-2922
- Fax: 973-377-8106
- Phone: 973-998-8898
- Fax: 973-998-8902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 25MD00172200 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: