Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 25MA08277400 | NJ |
N | 2081S0010X | Sports Medicine | 25MA08277400 | NJ |
N | 213ES0000X | Sports Medicine | 25MA08277400 | NJ |
NPI | 1437310448 |
---|---|
Provider Name | Dr. Joseph Jimenez |
First Address | Hackensack, NJ 07601-5171 |
Second Address | Hackensack, NJ 07601-5171 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 12/05/2021 |