Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MB09302100 | NJ |
N | 208000000X | Pediatrician | L0409069757844 | NJ |
Y | 2080P0204X | Pediatric Emergency Doctor | 25MB09302100 | NJ |
NPI | 1225323801 |
---|---|
Provider Name | Autumn J Dye |
First Address | Camden, NJ 08103-1155 |
Second Address | Camden, NJ 08103-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2011 |
Last Update Date | 08/07/2019 |