Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | A162224 | CA |
NPI | 1902267222 |
---|---|
Provider Name | Juanita Valdes Camacho |
First Address | Clifton, NJ 07012-6304 |
Second Address | Paterson, NJ 07503-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2016 |
Last Update Date | 20/01/2021 |