Healthcare Provider Details

I. General information

NPI: 1457367237
Provider Name (Legal Business Name): JOSEPH ANTHONY BISIGNARO III DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 01/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 S STATE ST
VINELAND NJ
08360-4851
US

IV. Provider business mailing address

92 S STATE ST
VINELAND NJ
08360-4851
US

V. Phone/Fax

Practice location:
  • Phone: 856-691-1287
  • Fax: 856-691-3037
Mailing address:
  • Phone: 856-691-1287
  • Fax: 856-691-3037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberMD002414
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: