Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 25MB02890400 | NJ |
NPI | 1366430324 |
---|---|
Provider Name | Dr. Ronald Librizzi |
First Address | Marlton, NJ 08053-3425 |
Second Address | Voorhees, NJ 08043-1548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 09/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2376903 | (05) | NJ |
B36394 | (02) | NJ |