Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 25MA09872100 | NJ |
NPI | 1043594344 |
---|---|
Provider Name | Dr. Ma. Conchitina Manas Fojas |
First Address | Englewood, NJ 07631-2409 |
Second Address | Englewood, NJ 07631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 01/07/2016 |