Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 25MA05851100 | NJ |
N | 2086S0127X | Trauma Surgeon | 25MA05851100 | NJ |
NPI | 1427123629 |
---|---|
Provider Name | Anne Mosenthal |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103-2496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 21/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5319803 | (05) | NJ |
F43216 | (02) | NJ |