Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | MA54672 | NJ |
NPI | 1780611574 |
---|---|
Provider Name | Dr. Stephen Bigelsen |
First Address | Mountain Lakes, NJ 07046-1009 |
Second Address | Dover, NJ 07801-1629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E68708 | (02) | NJ |