Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | MA061137 | NJ |
NPI | 1316032998 |
---|---|
Provider Name | Dr. Steven Jay Kanengiser |
First Address | Ridgewood, NJ 07450 |
Second Address | Ridgewood, NJ 07450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6266304 | (05) | NJ |
A65104 | (02) |