Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22DI01303900 | NJ |
NPI | 1083706527 |
---|---|
Provider Name | Dr. Frederick Harrison Ernst |
First Address | Boonton Township, NJ 07005 |
Second Address | Montville, NJ 07045-8922 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 16/02/2012 |