Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 25MA06720000 | NJ |
NPI | 1023018132 |
---|---|
Provider Name | Bani A Sarma |
First Address | Lawrenceville, NJ 08648-2302 |
Second Address | Lawrenceville, NJ 08648-2302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 24/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7572905 | (05) | NJ |
G51184 | (02) |