Individual
VINCENT ZICCARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 BERGEN ST, ROOM B-854, NEWARK, NJ 07103-2495
(973) 972-7462
(973) 972-7322
Mailing address
110 BERGEN ST, ROOM B-854, NEWARK, NJ 07103-2495
(973) 972-7462
(973) 972-7322
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
22DI01997900
NJ
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
25MA06705100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7827806
—
NJ
Enumeration date
04/06/2006
Last updated
04/09/2015
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