Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 25MA05251300 | NJ |
NPI | 1073513545 |
---|---|
Provider Name | Dr. Marvin Elliott Friedlander |
First Address | Union, NJ 07083-6634 |
Second Address | Union, NJ 07083-6634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2005 |
Last Update Date | 11/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0621501 | (05) | NJ |
223537990 | TAX ID (01) | NJ |
E22104 | (02) | NJ |