Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 22DI02653700 | NJ |
N | 1223E0200X | Endodontist | DE60295958 | WA |
N | 1223E0200X | Endodontist | DN22262 | FL |
NPI | 1073061297 |
---|---|
Provider Name | Dr. Marianella Natera-Fernandez |
First Address | Millburn, NJ 07041-1147 |
Second Address | Newark, NJ 07103-2495 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2016 |
Last Update Date | 16/09/2016 |