Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 25MA10607700 | NJ |
NPI | 1073952644 |
---|---|
Provider Name | Blair Faith Germain |
First Address | Neptune, NJ 07753-4488 |
Second Address | Neptune, NJ 07753-4488 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2013 |
Last Update Date | 11/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0695734 | (05) | NJ |