Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA03723200 | NJ |
NPI | 1073607321 |
---|---|
Provider Name | Girija S. Surya |
First Address | Holmdel, NJ 07733-1516 |
Second Address | Holmdel, NJ 07733-1516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 28/03/2015 |