Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 26NR07207400 | NJ |
NPI | 1932375896 |
---|---|
Provider Name | Evelyn David |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901-1935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 06/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0174939 | (05) | NJ |