Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 25MA09325900 | NJ |
NPI | 1144498718 |
---|---|
Provider Name | Dr. Leo Francis Doherty |
First Address | Basking Ridge, NJ 07920-2976 |
Second Address | Basking Ridge, NJ 07920-2976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2008 |
Last Update Date | 10/04/2015 |