Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | MA061670 | NJ |
NPI | 1013005107 |
---|---|
Provider Name | Margaret Masterson |
First Address | Redbank, NJ 07701 |
Second Address | New Brunswick, NJ 08901-1914 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6595405 | (05) | NJ |
E75568 | (02) |