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General NPI Number Information
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NPI Number | 1942270616
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Entity Type | Individual
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Provider Name | CARMINE JOSEPH DEFUSCO MD
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 224 TAYLOR MILLS RD SUITE 106
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City | MANALAPAN
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State | NJ
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Zip | 07726-3281
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Country | US
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Telephone | 732-462-0666
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Fax | 732-462-0992
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Provider Business Mailing Address
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Address Line | ATRIUM MEDICAL ARTS, SUITE 106 224 TAYLORS MILLS RD
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City | MANALAPAN
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State | NJ
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Zip | 07726-3281
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Country | US
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Telephone | 732-462-0666
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Fax | 732-462-0992
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | MA35320
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License Number State | NJ
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