Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 00MD2513 | NJ |
NPI | 1073825535 |
---|---|
Provider Name | Dr. Rhonda Lynn Hazell |
First Address | Cinnaminson, NJ 08077-1922 |
Second Address | Cinnaminson, NJ 08077-1922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2010 |
Last Update Date | 12/07/2010 |