Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MA07644200 | NJ |
NPI | 1285705665 |
---|---|
Provider Name | Dr. John G Ilagan |
First Address | Neptune, NJ 07753-4863 |
Second Address | Middletown, NY 10941-4028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 12/05/2017 |