Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB05525900 | NJ |
N | 207Q00000X | Family Doctor | BA2708418 | NJ |
NPI | 1609806454 |
---|---|
Provider Name | Dr. David Scott Abend |
First Address | Stratford, NJ 08084-1354 |
Second Address | Stratford, NJ 08084-1354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 01/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6596703 | (05) | NJ |
F24647 | (02) | NJ |