Provider Demographics
NPI:1366627028
Name:ANGELO DEL PRIORE DPM
Entity Type:Organization
Organization Name:ANGELO DEL PRIORE DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PRIORE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:973-998-8898
Mailing Address - Street 1:290 MADISON AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7401
Mailing Address - Country:US
Mailing Address - Phone:973-998-8898
Mailing Address - Fax:973-998-8902
Practice Address - Street 1:290 MADISON AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7401
Practice Address - Country:US
Practice Address - Phone:973-998-8898
Practice Address - Fax:973-998-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00172200213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
025623OtherMEDICARE GROUP
NJ1538279658OtherINDIVIDUAL NPI
480019748OtherRAILROAD MEDICARE
NJ1334701Medicaid
451300M52OtherMEDICARE INDV
451300M52OtherMEDICARE INDV
NJT45191Medicare UPIN