Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MA43221 | NJ |
NPI | 1003949322 |
---|---|
Provider Name | Dr. Edward A Braunstein |
First Address | Manalapan, NJ 07724 |
Second Address | Marlboro, NJ 07746-1429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 15/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0854506 | (05) | NJ |
D18446 | (02) | NJ |