Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 25MA02211300 | NJ |
NPI | 1003859935 |
---|---|
Provider Name | Catherine A Michon |
First Address | Voorhees, NJ 08043-2106 |
Second Address | Voorhees, NJ 08043-2106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 05/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0543608 | (05) | NJ |
D06861 | (02) | NJ |