Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 25MA04615000 | NJ |
NPI | 1134173065 |
---|---|
Provider Name | Danilo Veluz Palomares |
First Address | Jersey City, NJ 07306-5507 |
Second Address | Jersey City, NJ 07306-5507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3693503 | (05) | NJ |
C56742 | (02) | NJ |