Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 25MA05735200 | NJ |
NPI | 1235148198 |
---|---|
Provider Name | Dr. Taonei I Mushayandebvu |
First Address | Jersey City, NJ 07306 |
Second Address | Jersey City, NJ 07306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2006 |
Last Update Date | 02/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5608007 | (05) | NJ |
F73682 | (02) | NJ |