Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | C10006637 | DE |
NPI | 1487701389 |
---|---|
Provider Name | Dr. Bruce A. Kaiser |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 15/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2234700 | (05) | NJ |
2458822 | (05) | NY |
6499210 | (05) | MD |
908269 | (05) | PA |
B41165 | (02) |