Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MA036270 | NJ |
NPI | 1154569044 |
---|---|
Provider Name | Dr. Jose Francisco Colon |
First Address | Newark, NJ 07104-3110 |
Second Address | Newark, NJ 07104-3110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2009 |
Last Update Date | 30/01/2009 |