Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 25MA08145100 | NJ |
NPI | 1326017567 |
---|---|
Provider Name | Dr. Eduardo Sembrano |
First Address | Buffalo, NY 14267-0002 |
Second Address | Long Branch, NJ 07740-6211 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 13/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7446209 | (05) | NJ |
G56293 | (02) | NJ |