Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | D102102800 | NJ |
NPI | 1548375280 |
---|---|
Provider Name | Dr. Steven Jay Garin |
First Address | Marlton, NJ 08055-2098 |
Second Address | Marlton, NJ 08055-2098 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 02/10/2015 |