Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 40QA00681400 | NJ |
NPI | 1003971474 |
---|---|
Provider Name | Mr. Enrique H Arencibia |
First Address | Hoboken, NJ 07030-4908 |
Second Address | Hoboken, NJ 07030-4908 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2006 |
Last Update Date | 08/07/2007 |