Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | MA55377 | NJ |
Y | 2086S0127X | Trauma Surgeon | MA55377 | NJ |
NPI | 1114096815 |
---|---|
Provider Name | Jeffrey Hammond |
First Address | Gladstone, NJ 07934-2123 |
Second Address | Gladstone, NJ 07934-2123 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 31/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3614204 | (05) | NJ |
D63559 | (02) | NJ |