MEDICARE: DR. VINCENT J EMILIANI MD

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
1	174400000X	Specialist	544885A9S	NJ

Other Identifiers

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

General Provider Information

NPI Number	:	1487634457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT J EMILIANI MD

Provider Business Mailing Address
First Line	:	16 POCONO RD
Second Line	:	STE 201
City	:	DENVILLE
State	:	NJ
Zip	:	07834-2901
Country	:	US
Telephone Number	:	973-627-4430
Fax Number	:	973-586-2336

Provider Business Practice Location Address
First Line	:	16 POCONO RD
Second Line	:	STE 201
City	:	DENVILLE
State	:	NJ
Zip	:	07834-2901
Country	:	US
Telephone Number	:	973-627-4430
Fax Number	:	973-586-2336

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	10/29/2009

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