Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 049417 | CT |
NPI | 1053616631 |
---|---|
Provider Name | Jodi V Fox-Mellul |
First Address | Mullica Hill, NJ 08062-1502 |
Second Address | Mullica Hill, NJ 08062-1502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2011 |
Last Update Date | 01/04/2014 |