Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MA039740 | NJ |
NPI | 1134236177 |
---|---|
Provider Name | Dr. Diane J Kmec |
First Address | Skillman, NJ 08558-1722 |
Second Address | Skillman, NJ 08558-1722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 09/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C56320 | (02) | NJ |