Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 25MB10591700 | NJ |
NPI | 1043637192 |
---|---|
Provider Name | Dr. Fadwa Sumrein |
First Address | Clifton, NJ 07012-1670 |
Second Address | Clifton, NJ 07012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2014 |
Last Update Date | 25/11/2019 |