Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | MD00276600 | NJ |
NPI | 1104894054 |
---|---|
Provider Name | Dr. Margaret Portela |
First Address | Kearny, NJ 07032-2028 |
Second Address | Union City, NJ 07087-5172 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 20/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0039047 | (05) | NJ |
3354601 | (05) | NJ |
U96650 | (02) | NJ |