Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 25MA049958 | NJ |
NPI | 1053316653 |
---|---|
Provider Name | Dr. Michael L Margolin |
First Address | Cranford, NJ 07016-2441 |
Second Address | Cranford, NJ 07016-2441 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 01/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5062004 | (05) | NJ |
A64874 | (02) | NJ |