Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 058128 | NY |
N | 213EG0000X | General Practice | 058128 | NY |
Y | 1223G0001X | General Practice | 22DI02673800 | NJ |
Y | 213EG0000X | General Practice | 22DI02673800 | NJ |
NPI | 1003221656 |
---|---|
Provider Name | Dr. Erika Janelle Donovan |
First Address | Paramus, NJ 07652-2901 |
Second Address | Paramus, NJ 07652-2901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 16/01/2019 |