Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MA51333 | NJ |
Y | 207RI0011X | Interventional Cardiology | 25MA05133300 | NJ |
NPI | 1003880535 |
---|---|
Provider Name | Dr. Rita Watson |
First Address | Neptune, NJ 07753-6141 |
Second Address | Long Branch, NJ 07740-5219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 14/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3874702 | (05) | NJ |
A61464 | (02) | NJ |