Mico, Mario
Mico, Mario is an individual health care provider with primary practice located at 913 Main Ave , Passaic NJ 07055-8540. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Mico, Mario can be contacted via phone (973) 458-8000.Contact Information
Primary practice address
913 Main Ave
Passaic NJ 07055-8540
Phone: (973) 458-8000
Fax: (973) 458-8425
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 25MA08315100 | New Jersey |
Profile Details
| NPI number | 1730221714 |
|---|---|
| LBN Legal business name | Mico, Mario |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Feb 5th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730221714 | NPPES |
| Texas | MEDICAID | 117705702 |
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