Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MA50470 | NJ |
NPI | 1093742793 |
---|---|
Provider Name | Dr. Frances Barbara Pelliccia |
First Address | New Brunswick, NJ 08901-3653 |
Second Address | New Brunswick, NJ 08901-3653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 05/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1901206 | (05) | NJ |
E22019 | (02) | NJ |