Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 25MA02985400 | NJ |
NPI | 1467415042 |
---|---|
Provider Name | Dr. Jeffrey D Roffman |
First Address | Tinton Falls, NJ 07701 |
Second Address | Tinton Falls, NJ 07701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B19631 | (02) |