Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 25MA07925200 | NJ |
NPI | 1558300145 |
---|---|
Provider Name | Dr. Jose A Contreras |
First Address | Hackensack, NJ 07601-1997 |
Second Address | Hackensack, NJ 07601-1997 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 11/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I01155 | (02) |