Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MA070986 | NJ |
NPI | 1326040155 |
---|---|
Provider Name | Dr. Clodualdo S Orquiza |
First Address | Linwood, NJ 08221-1046 |
Second Address | Linwood, NJ 08221-1046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H20469 | (02) | NJ |