Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MA065475 | NJ |
NPI | 1447239959 |
---|---|
Provider Name | Dr. Henry Ernest Sprance |
First Address | West Long Branch, NJ 07764-1177 |
Second Address | West Long Branch, NJ 07764-1177 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2006 |
Last Update Date | 24/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7284306 | (05) | NJ |
G54174 | (02) | NJ |