Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 25MB07361000 | NJ |
NPI | 1194718130 |
---|---|
Provider Name | Dr. Boris Epstein |
First Address | East Brunswick, NJ 08816-4098 |
Second Address | E Brunswick, NJ 08816-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 28/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8905304 | (05) | NJ |