MEDICARE: DR. EARL DIPIRRO 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	208200000X	Plastic Surgery Physician	25MA019758	NJ

General Provider Information

NPI Number	:	1902866833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EARL DIPIRRO MD

Provider Business Mailing Address
First Line	:	24 EDGEWOOD DRIVE
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	NJ
Zip	:	07676
Country	:	US
Telephone Number	:	201-722-9013
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 EDGEWOOD DRIVE
Second Line	:
City	:	WASHINGTON TOWNSHIP
State	:	NJ
Zip	:	07676
Country	:	US
Telephone Number	:	201-722-9013
Fax Number	:	201-722-9013

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

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	07/08/2007

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