Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 175626 | NY |
N | 208000000X | Pediatrician | 175626 | NY |
Y | 208000000X | Pediatrician | 25MA06903600 | NJ |
N | 2080N0001X | Neonatal-Perinatal Doctor | 175626 | NY |
NPI | 1700085883 |
---|---|
Provider Name | Dr. Robert J Vosatka |
First Address | Marlton, NJ 08053-4112 |
Second Address | Succasunna, NJ 07876-1452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2007 |
Last Update Date | 06/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
080225000105 | FIDELIS CARE NY (01) | NY |