Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA05494400 | NJ |
Y | 2084N0402X | Child Neurologist | 25MA05494400 | NJ |
NPI | 1093759938 |
---|---|
Provider Name | Judy Woo |
First Address | Fair Lawn, NJ 07410-1552 |
Second Address | Fair Lawn, NJ 07410-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 30/08/2012 |