# DR. WILLIAM SALVATOR RANDAZZO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1578573028
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 29669 | SC | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | 25MA04387300 | NJ | — |

## Other

- **Enumeration date:** 08/08/2006
- **Last updated:** 10/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 201940413 | TAX ID | NJ |
| 05 | — | 296699 | — | SC |