Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 25MA08446800 | NJ |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 25MA08446800 | NJ |
NPI | 1174788467 |
---|---|
Provider Name | Dr. Geronima G Alday |
First Address | Freehold, NJ 07728-2579 |
Second Address | Freehold, NJ 07728-2579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2008 |
Last Update Date | 31/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0174190 | (05) | NJ |