Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 38MC00755400 | NJ |
NPI | 1699333120 |
---|---|
Provider Name | Katarzyna Ernst |
First Address | Madison, NJ 07940-2165 |
Second Address | Madison, NJ 07940-2165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2019 |
Last Update Date | 30/05/2019 |