Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | MA43991 | NJ |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | MA43991 | NJ |
NPI | 1881688166 |
---|---|
Provider Name | Dr. Kenneth Remsen |
First Address | Riverdale, NJ 07457-1625 |
Second Address | Riverdale, NJ 07457-1625 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 05/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C59830 | (02) | NJ |