Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | MA048107 | NJ |
NPI | 1194863407 |
---|---|
Provider Name | Dr. Thomas Martin Connor |
First Address | West Orange, NJ 07052 |
Second Address | West Orange, NJ 07052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 10/08/2012 |