Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 25MP00562900 | NJ |
NPI | 1104395193 |
---|---|
Provider Name | Kristina Mischler |
First Address | Tinton Falls, NJ 07701-4947 |
Second Address | New Brunswick, NJ 08901-2065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2018 |
Last Update Date | 23/07/2021 |