Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | DI017865 | NJ |
Y | 213EG0000X | General Practice | DI017865 | NJ |
NPI | 1003019910 |
---|---|
Provider Name | Dr. Jonathan Min |
First Address | Matawan, NJ 07747-2227 |
Second Address | Matawan, NJ 07747-2227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2007 |
Last Update Date | 08/07/2007 |