Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 26NJ00960500 | NJ |
NPI | 1063062933 |
---|---|
Provider Name | Kristen Garofalo |
First Address | Netcong, NJ 07857-1707 |
Second Address | Newark, NJ 07112-2027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2019 |
Last Update Date | 10/04/2020 |