Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 25MA07670900 | NJ |
N | 2080P0216X | Pediatric Rheumatologist | MA76709 | NJ |
NPI | 1326122565 |
---|---|
Provider Name | Dr. Lakshmi N. Moorthy |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 23/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0042412 | (05) | NJ |
I18862 | (02) |