Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | D11179 | NJ |
NPI | 1083782841 |
---|---|
Provider Name | Dr. Stuart Dean Neiss |
First Address | Westfield, NJ 07090-2126 |
Second Address | Westfield, NJ 07090-2126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 08/07/2007 |