Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | N0116 | TX |
N | 2080P0207X | Pediatric Hematology-Oncologist | 25MA08790800 | NJ |
NPI | 1265743108 |
---|---|
Provider Name | Dr. Ionela Iacobas |
First Address | New Brunswick, NJ 08901-1766 |
Second Address | New Brunswick, NJ 08901-1766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 27/05/2011 |