Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | MD001806 | NJ |
Y | 222Z00000X | Podiatrist | MD001806 | NJ |
NPI | 1013925270 |
---|---|
Provider Name | Mr. John F Connors |
First Address | Little Silver, NJ 07739 |
Second Address | Little Silver, NJ 07739 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5000408 | (05) | NJ |
T45710 | (02) |