Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 25MA02165000 | NJ |
N | 207ND0101X | MOHS-Micrographic Surgeon | 25MA02165000 | NJ |
N | 207NS0135X | Procedural Dermatology | 25MA02165000 | NJ |
NPI | 1467566208 |
---|---|
Provider Name | Emanuel G Kuflik |
First Address | Lakewood, NJ 08701-1345 |
Second Address | Lakewood, NJ 08701-1345 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 28/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C56028 | (02) |