Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 25MA10658200 | NJ |
NPI | 1326468422 |
---|---|
Provider Name | Dr. Brian Lee Bones |
First Address | Little Silver, NJ 07739-1126 |
Second Address | Paterson, NJ 07514-1527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2014 |
Last Update Date | 20/07/2021 |