Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 25MA10605400 | NJ |
NPI | 1134562143 |
---|---|
Provider Name | Christen Lennon Caloway |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 24/07/2019 |