Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MA36548 | NJ |
NPI | 1366401945 |
---|---|
Provider Name | Dr. Abraham D. Morganoff |
First Address | Warren, NJ 07059-5650 |
Second Address | Warren, NJ 07059-5650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 29/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C60053 | (02) | NJ |