Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DI19555 | NJ |
NPI | 1043397755 |
---|---|
Provider Name | Dr. Amy Elizabeth James |
First Address | Haddonfield, NJ 08033-2300 |
Second Address | Haddonfield, NJ 08033-2300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DI19555 | LICENSE (01) | NJ |