Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | MA67225 | NJ |
NPI | 1043204332 |
---|---|
Provider Name | Dr. Jeffrey Ginsburg |
First Address | Riverdale, NJ 07457-1625 |
Second Address | Riverdale, NJ 07457-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G73467 | (02) | NJ |