Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | CI0007947 | DE |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | C10007947 | DE |
NPI | 1255385589 |
---|---|
Provider Name | Dr. Roger Kerzner |
First Address | Newark, DE 19702-5438 |
Second Address | Newark, DE 19702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 08/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1255385589 | (05) | DE |
I57322 | (02) | DE |