Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 25MA06480600 | NJ |
Y | 111NI0900X | Internist | 25MA06480600 | NJ |
N | 207RH0002X | Hospice and Palliative Medicine | 25MA06480600 | NJ |
NPI | 1366435216 |
---|---|
Provider Name | Dr. Brenda M Matti-Orozco |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 16/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01659672 | (05) | NY |
G28235 | (02) | NY |