Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | MA40059 | NJ |
NPI | 1053381624 |
---|---|
Provider Name | Dr. Marsha Kallich |
First Address | East Brunswick, NJ 08816-5426 |
Second Address | East Brunswick, NJ 08816-5426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 28/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0848107 | (05) | NJ |
221957468 | TAX ID (01) | NJ |
C60478 | (02) | NJ |