Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 25MA09870400 | NJ |
NPI | 1073883229 |
---|---|
Provider Name | Dr. Suhalia Bakerywala |
First Address | Wyckoff, NJ 07481-1438 |
Second Address | Wyckoff, NJ 07481-1934 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2012 |
Last Update Date | 03/09/2021 |