Individual
ISABEL DETRIZIO CAROTENUTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24 HERITAGE DR, EAST HANOVER, NJ 07936-3930
(973) 884-3155
(973) 884-3523
Mailing address
24 HERITAGE DR, EAST HANOVER, NJ 07936-3930
(973) 884-3155
(973) 884-3523
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MAO45465
NJ
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
MAO45465
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156 6202
—
NJ
Enumeration date
11/03/2006
Last updated
08/18/2010
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