Individual
PAUL P LOGRASSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
175 MADISON AVE, MOUNT HOLLY, NJ 08060-2038
(609) 261-7095
(609) 261-3751
Mailing address
175 MADISON AVE, MOUNT HOLLY, NJ 08060-2038
(609) 261-7095
(609) 261-3751
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MB004496100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060241
—
NJ
Enumeration date
10/14/2005
Last updated
06/04/2010
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