Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MA03151000 | NJ |
Y | 208600000X | Surgeon | MA03151000 | NJ |
NPI | 1023072469 |
---|---|
Provider Name | Edgar Ramos Hobayan |
First Address | South Plainfield, NJ 07080 |
Second Address | South Plainfield, NJ 07080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3638901 | (05) | NJ |
C54333 | (02) |