Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 25MA06308200 | NJ |
Y | 207R00000X | Internist | 25MA06308200 | NJ |
Y | 111NI0900X | Internist | 25MA06308200 | NJ |
NPI | 1003818881 |
---|---|
Provider Name | Dr. James N Ezema |
First Address | Ringoes, NJ 08551-2056 |
Second Address | East Orange, NJ 07018-2819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 22/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6862004 | (05) | NJ |
G24472 | (02) | NJ |