Individual
JOAQUIN CANTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
416 BELLEVUE AVE, STE 104, TRENTON, NJ 08618-4513
(609) 396-4700
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
05329100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4010001
—
NJ
Enumeration date
07/29/2006
Last updated
11/01/2007
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