Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MA062489 | NJ |
NPI | 1033153911 |
---|---|
Provider Name | John M Owens |
First Address | Teaneck, NJ 07666-3144 |
Second Address | Teaneck, NJ 07666-3144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 04/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6595600 | (05) | NJ |