Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 40QA01943500 | NJ |
NPI | 1033717608 |
---|---|
Provider Name | Maria A Culver |
First Address | Matawan, NJ 07747-2132 |
Second Address | Matawan, NJ 07747-2132 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2020 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
40QA01943500 | LICENSED (01) | NJ |