Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 25ME00027201 | NJ |
NPI | 1063440212 |
---|---|
Provider Name | Glorya E Matthews |
First Address | Toms River, NJ 08753-3348 |
Second Address | Toms River, NJ 08753-3348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 08/07/2007 |