Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 000107 | NY |
NPI | 1114559994 |
---|---|
Provider Name | Dr. Daniela Gurpegui Abud |
First Address | Fort Lee, NJ 07024-3859 |
Second Address | Fort Lee, NJ 07024-3806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2020 |
Last Update Date | 28/01/2022 |