Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 25MA05228900 | NJ |
NPI | 1407860406 |
---|---|
Provider Name | Dr. Dorothy Stein Bisberg |
First Address | South Orange, NJ 07079-1630 |
Second Address | West Orange, NJ 07052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 06/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2270803 | (05) | NJ |
A61969 | (02) |