Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 25MB08883700 | NJ |
NPI | 1003112426 |
---|---|
Provider Name | Dr. Maria Cassotis |
First Address | Bedminster, NJ 07921 |
Second Address | Camden, NJ 08103-1461 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2011 |
Last Update Date | 02/02/2011 |