Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MA08046400 | NJ |
NPI | 1043254535 |
---|---|
Provider Name | Dr. Robert H Pittman |
First Address | Emerson, NJ 07630-1396 |
Second Address | Emerson, NJ 07630-1396 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 20/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H58110 | (02) | NJ |