Provider Demographics
NPI:1639192230
Name:PAOLINO, JAMES S (MD,FACR)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:PAOLINO
Suffix:
Gender:M
Credentials:MD,FACR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2168 MILLBURN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2640
Mailing Address - Country:US
Mailing Address - Phone:973-762-3738
Mailing Address - Fax:973-762-7878
Practice Address - Street 1:2168 MILLBURN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2640
Practice Address - Country:US
Practice Address - Phone:973-762-3738
Practice Address - Fax:973-762-7878
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA025728174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist