Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 25MA10308800 | NJ |
NPI | 1417215971 |
---|---|
Provider Name | Dr. David Folk |
First Address | Paterson, NJ 07503-2621 |
Second Address | Paterson, NJ 07503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 23/03/2020 |