Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 25MA09607400 | NJ |
N | 207RC0200X | Critical Care Medicine | MD445793 | PA |
NPI | 1043410251 |
---|---|
Provider Name | Dr. Balaji Yegneswaran |
First Address | New Brunswick, NJ 08901-1766 |
Second Address | New Brunswick, NJ 08901-1766 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2007 |
Last Update Date | 14/09/2016 |