Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 25MB06482800 | NJ |
NPI | 1427020346 |
---|---|
Provider Name | Eric Alves |
First Address | Vineland, NJ 08360-6912 |
Second Address | Vineland, NJ 08360-6912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 18/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G86897 | (02) | NJ |