Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | MA72835 | NJ |
NPI | 1285623132 |
---|---|
Provider Name | Dr. Tanveer Ahmed Janjua |
First Address | Bedminster, NJ 07921-2612 |
Second Address | Bedminster, NJ 07921-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2005 |
Last Update Date | 16/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G91008 | (02) | NJ |