Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 25MA04935600 | NJ |
NPI | 1265729065 |
---|---|
Provider Name | Dr. Estrella Atanacio Ronsayro |
First Address | Sewell, NJ 08080-2708 |
Second Address | Camden, NJ 08103-1121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 30/06/2011 |