Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00426900 | NJ |
NPI | 1003973843 |
---|---|
Provider Name | Dr. Kathryn Beckett |
First Address | Marlton, NJ 08053-1523 |
Second Address | Marlton, NJ 08053-1523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
536899 | (02) | NJ |