Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213EP1101X | Primary Podiatric Medicine | MD01033 | NJ |
N | 213ES0103X | Foot & Ankle Surgery | MD01033 | NJ |
NPI | 1336196567 |
---|---|
Provider Name | Dr. Bruce J Folbaum |
First Address | Cherry Hill, NJ 08034-1906 |
Second Address | Cherry Hill, NJ 08034-1906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2466309 | (05) | NJ |
T44765 | (02) | NJ |