Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MA30109 | NJ |
NPI | 1003911934 |
---|---|
Provider Name | Freidoon Behin |
First Address | Jersey City, NJ 07306-1133 |
Second Address | Jersey City, NJ 07306-1133 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C56133 | (02) | NJ |