Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 25MA03844200 | NJ |
NPI | 1841291291 |
---|---|
Provider Name | Cheryl S Reid |
First Address | Moorestown, NJ 08057-2137 |
Second Address | Moorestown, NJ 08057-2137 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 26/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1831500 | (05) | NJ |
D19657 | (02) | NJ |