Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 25MA03451400 | NJ |
NPI | 1326153248 |
---|---|
Provider Name | Mirseyed A Mohit-Tabatabai |
First Address | South Orange, NJ 07079-0534 |
Second Address | East Orange, NJ 07018-1023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |