Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 25MW00003400 | NJ |
NPI | 1063005635 |
---|---|
Provider Name | Angelica Tapia Ko |
First Address | East Hanover, NJ 07936-2941 |
Second Address | East Hanover, NJ 07936-2941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2021 |
Last Update Date | 15/02/2021 |