Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA07772000 | NJ |
NPI | 1053373613 |
---|---|
Provider Name | Anoop Porwal |
First Address | Toms River, NJ 08755-6434 |
Second Address | Toms River, NJ 08755-6434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 16/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I22574 | (02) | NJ |