Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DI02584200 | NJ |
NPI | 1003216797 |
---|---|
Provider Name | Dr. Aneeza Rehman |
First Address | Secaucus, NJ 07094-2931 |
Second Address | Secaucus, NJ 07094-2931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2014 |
Last Update Date | 29/08/2014 |