Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MA02911800 | NJ |
NPI | 1285729566 |
---|---|
Provider Name | Dr. Warren Sweberg |
First Address | East Brunswick, NJ 08816 |
Second Address | East Brunswick, NJ 08816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 17/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0288209 | (05) | NJ |
222130958 | TAX ID (01) | NJ |