Provider Demographics
NPI:1275613226
Name:PARISI, JAMES ANTHONY (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:PARISI
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 NEWARK AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-1185
Mailing Address - Country:US
Mailing Address - Phone:973-751-3284
Mailing Address - Fax:973-751-2394
Practice Address - Street 1:50 NEWARK AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1185
Practice Address - Country:US
Practice Address - Phone:973-751-3284
Practice Address - Fax:973-751-2394
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA01984300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ052944Medicare ID - Type Unspecified
NJD06105Medicare UPIN