Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 25MA10654300 | NJ |
N | 208200000X | Surgeon | 25MA10654300 | NJ |
N | 208600000X | Surgeon | 25MA10654300 | NJ |
NPI | 1407021132 |
---|---|
Provider Name | Dr. Keri Elizabeth Lunsford |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2008 |
Last Update Date | 04/10/2019 |