Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 25MA04362600 | NJ |
NPI | 1083614150 |
---|---|
Provider Name | Dr. Scott Evan Eder |
First Address | Plainsboro, NJ 08536-3030 |
Second Address | Plainsboro, NJ 08536-3030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 15/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4597109 | (05) | NJ |
D06295 | (02) |