Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 25MA03895500 | NJ |
Y | 2080P0214X | Pediatric Pulmonologist | MA3895500 | NJ |
NPI | 1104882109 |
---|---|
Provider Name | Charles K. Dadzie |
First Address | Neptune, NJ 07753-4488 |
Second Address | Neptune, NJ 07753-4488 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 12/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0452009 | (05) | NJ |