Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | 32WG04920000 | NJ |
NPI | 1326502022 |
---|---|
Provider Name | Mr. Daniel Koye |
First Address | Rutherford, NJ 07070-2072 |
Second Address | Rutherford, NJ 07070-2072 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2019 |
Last Update Date | 27/01/2019 |