Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MA07571 | NJ |
NPI | 1194722991 |
---|---|
Provider Name | Kristen M Sikorski |
First Address | Skillman, NJ 08558-2621 |
Second Address | Skillman, NJ 08558-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006025 | (05) | NJ |
05551668 | ECFMG (01) | |
BS8356847 | DEA (01) | NJ |
H93810 | (02) | NJ |