Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25MA07463200 | NJ |
N | 207R00000X | Internist | 25MA07463200 | NJ |
N | 111NI0900X | Internist | 25MA07463200 | NJ |
NPI | 1205852464 |
---|---|
Provider Name | Jin Ping Guo |
First Address | Marlton, NJ 08053-3426 |
Second Address | Marlton, NJ 08053-3125 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 21/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9118403 | (05) | NJ |
H67491 | (02) | NJ |