Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VX0201X | Gynecologic Oncologist | 258218 | NY |
Y | 207VX0201X | Gynecologic Oncologist | 25MA09772500 | NJ |
NPI | 1578727574 |
---|---|
Provider Name | Dr. Merieme Klobocista |
First Address | Hackensack, NJ 07601-2191 |
Second Address | Hackensack, NJ 07601-2191 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 26/01/2022 |