Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 25MA02828000 | NJ |
NPI | 1508935248 |
---|---|
Provider Name | Constancia Somera Uy |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103-2425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 20/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3791807 | (05) | NJ |
E88017 | (02) |