Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA 00519500 | NJ |
N | 152W00000X | Optometrist | 7431-P | PA |
NPI | 1003927443 |
---|---|
Provider Name | John M Garfield |
First Address | Medford, NJ 08055-0099 |
Second Address | Manahawkin, NJ 08050-2821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U42120 | MEDICARE UPIN (01) |