Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 25MB007885200 | NJ |
Y | 207RH0002X | Hospice and Palliative Medicine | 25MB07885200 | NJ |
NPI | 1336195676 |
---|---|
Provider Name | Marianne Holler |
First Address | Holmdel, NJ 07733-2136 |
Second Address | Holmdel, NJ 07733-2136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 01/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0109428 | (05) | NJ |
I54623 | (02) | NJ |