Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA07485400 | NJ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD060574L | PA |
N | 207YS0123X | Facial Plastic Surgeon | 25MA07485400 | NJ |
NPI | 1316975220 |
---|---|
Provider Name | Daniel Grant Becker |
First Address | Sewell, NJ 08080-2359 |
Second Address | Sewell, NJ 08080-2359 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 22/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G13507 | (02) | NJ |