Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | MA60621 | NJ |
NPI | 1053364000 |
---|---|
Provider Name | Dr. Javier Aisenberg |
First Address | Hackensack, NJ 07601-1914 |
Second Address | Hackensack, NJ 07601-1914 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F-86431 | (02) | NJ |