Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 22DI00906300 | NJ |
NPI | 1033152251 |
---|---|
Provider Name | Dr. Ira J Saber |
First Address | Convent Station, NJ 07961 |
Second Address | Newark, NJ 07101-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2811804 | (05) | NJ |
U23963 | (02) | NJ |