Provider Demographics
NPI:1548656820
Name:ALBANO, JOSEPH (DO)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ALBANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 CLAREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2812
Mailing Address - Country:US
Mailing Address - Phone:973-783-1444
Mailing Address - Fax:973-509-8421
Practice Address - Street 1:242 CLAREMONT AVE
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2812
Practice Address - Country:US
Practice Address - Phone:973-783-1444
Practice Address - Fax:973-509-8421
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS4592207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MB10900900OtherNJ DIVISION OF CONSUMER AFFAIRS
TXS4592OtherTMB