Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 25MA06250800 | NJ |
NPI | 1124093612 |
---|---|
Provider Name | Dr. Jeanne A. Craft |
First Address | Basking Ridge, NJ 07920-2507 |
Second Address | Livingston, NJ 07039-5672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6606601 | (05) | NJ |
G25690 | (02) | NJ |