Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 22DI01433600 | NJ |
NPI | 1245384080 |
---|---|
Provider Name | Dr. Robert George Eramian |
First Address | Boonton, NJ 07005-2328 |
Second Address | Jersey City, NJ 07306-1133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |