Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 25MA05012800 | NJ |
NPI | 1528155900 |
---|---|
Provider Name | Dr. Frank Kern |
First Address | Brigantine, NJ 08203-1927 |
Second Address | Brigantine, NJ 08203-1927 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C29928 | (02) | NJ |