Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 25MA07797700 | NJ |
NPI | 1023041472 |
---|---|
Provider Name | Dr. Shirley Bembo |
First Address | Princeton, NJ 08540-2757 |
Second Address | Princeton, NJ 08540-2757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 27/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I22214 | (02) |