Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 38MC00617600 | NJ |
NPI | 1003949272 |
---|---|
Provider Name | Dr. Stanley Nosal III |
First Address | North Brunswick, NJ 08902-1138 |
Second Address | North Brunswick, NJ 08902-1138 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 07/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V05303 | (02) | NJ |