Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 22DI01304400 | NJ |
NPI | 1063433464 |
---|---|
Provider Name | Dr. Maxine Feinberg |
First Address | Cranford, NJ 07016-2435 |
Second Address | Cranford, NJ 07016-2435 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |