Provider Demographics
NPI:1114904752
Name:CINZIO, JOSEPH RUDOLPH (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RUDOLPH
Last Name:CINZIO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:378 MACARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-1147
Mailing Address - Country:US
Mailing Address - Phone:973-478-0016
Mailing Address - Fax:
Practice Address - Street 1:378 MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1147
Practice Address - Country:US
Practice Address - Phone:973-478-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00076700213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT82386Medicare UPIN
NJ051013Medicare ID - Type Unspecified