Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 25MB06514100 | NJ |
N | 207V00000X | Obstetrician & Gynecologist | MB65141 | NJ |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25MB06514100 | NJ |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | NJMB65141 | NJ |
N | 2086S0122X | Plastic and Reconstructive Surgery | 25MB06514100 | NJ |
NPI | 1952495798 |
---|---|
Provider Name | Adam S Holzberg |
First Address | Stratford, NJ 08084-1354 |
Second Address | Stratford, NJ 08084-1354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 27/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
785781 | MEDICARE (01) | NJ |
8270104 | (05) | NJ |
H13236 | (02) |