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Individual

EDWARD D MASTROMONACO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO PA

Contact information

Practice address
696 AVE C, BAYONNE, NJ 07002
(201) 339-2284
Mailing address
696 AVE C, BAYONNE, NJ 07002
(201) 339-2284

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MB233406
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
410562
PTAN NEW JERSEY 410562
NJ
Enumeration date
07/25/2006
Last updated
02/07/2013
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