Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | MA05654700 | NJ |
N | 207VX0000X | Obstetrician | MA05654700 | NJ |
NPI | 1073678280 |
---|---|
Provider Name | Isaac L Victor |
First Address | Cranford, NJ 07016-2944 |
Second Address | Cranford, NJ 07016-2944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 08/07/2007 |