Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 25MA07653500 | NJ |
NPI | 1033211255 |
---|---|
Provider Name | Madhu Jain |
First Address | Lawrenceville, NJ 08648 |
Second Address | Lawrenceville, NJ 08648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G35381 | (02) |