Provider Demographics
NPI:1619238433
Name:IMBRIALE, JAMES (MSED)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:IMBRIALE
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 BARBARA TER
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1247
Mailing Address - Country:US
Mailing Address - Phone:732-275-1513
Mailing Address - Fax:
Practice Address - Street 1:20 BARBARA TER
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-1247
Practice Address - Country:US
Practice Address - Phone:732-275-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist