Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 46TR001184 | NJ |
NPI | 1235183062 |
---|---|
Provider Name | Dr. Prashant M Junankar |
First Address | Clifton, NJ 07011-4041 |
Second Address | Clifton, NJ 07011-4041 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 16/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223197291 | TAX ID NYMBEER (01) | NJ |
46TR118400 | STATE OF NJ LICENSE (01) | NJ |