Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 37769 | NJ |
NPI | 1194742783 |
---|---|
Provider Name | Dr. Jan R Soriano |
First Address | Somerset, NJ 08873-4819 |
Second Address | Somerset, NJ 08873-4819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S 43588 | (02) |