Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 25MA09707600 | NJ |
Y | 207RX0202X | Medical Oncology | 25MA09707600 | NJ |
NPI | 1295994614 |
---|---|
Provider Name | Dr. Jamie Lynn Koprivnikar |
First Address | Hackensack, NJ 07601-2191 |
Second Address | Hackensack, NJ 07601-2191 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 26/01/2022 |