Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 25MA-08729000 | NJ |
NPI | 1457391880 |
---|---|
Provider Name | Dr. Roberto A Jodorkovsky |
First Address | Paterson, NJ 07503-2621 |
Second Address | Paterson, NJ 07503-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 17/06/2010 |