Organization
S. DESIDERIO PENSO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SILVESTRE DESIDERIO PENSO MD (PRESIDENT)
(609) 645-3333
Entity
Organization
Contact information
Practice address
1 EVERGREEN RD, LINWOOD, NJ 08221-1344
(609) 645-3333
Mailing address
1100 CLEMATIS AVE, PLEASANTVILLE, NJ 08232-3302
(609) 645-3333
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
28628
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3234100
—
NJ
Enumeration date
08/12/2008
Last updated
05/18/2009
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