Provider Demographics
NPI:1427234772
Name:COMO, BIAGIO (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:
First Name:BIAGIO
Middle Name:
Last Name:COMO
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CORNWALL DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3311
Mailing Address - Country:US
Mailing Address - Phone:732-698-1000
Mailing Address - Fax:732-698-1008
Practice Address - Street 1:3 CORNWALL DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3311
Practice Address - Country:US
Practice Address - Phone:732-698-1000
Practice Address - Fax:732-698-1008
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-17
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011205363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant