Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA06627400 | NJ |
NPI | 1083681282 |
---|---|
Provider Name | Cristina E Cicogna |
First Address | Hackensack, NJ 07601-1997 |
Second Address | Hackensack, NJ 07601-1997 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 26/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F20129 | (02) | NJ |