Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MA60442 | NJ |
NPI | 1467474536 |
---|---|
Provider Name | Karen Sue Ziemke |
First Address | West Orange, NJ 07052-1144 |
Second Address | West Orange, NJ 07052-1144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 09/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F90180 | (02) |