Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 25MD00209300 | NJ |
Y | 222Z00000X | Podiatrist | 25MD00209300 | NJ |
N | 213E00000X | Podiatrist | MD002093 | NJ |
N | 222Z00000X | Podiatrist | MD002093 | NJ |
NPI | 1063400307 |
---|---|
Provider Name | Dr. Donna Marie Barrese |
First Address | Lawrence Township, NJ 08648-0566 |
Second Address | Lawrenceville, NJ 08648-1086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U42427 | (02) | NJ |