Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | 25MP00059000 | NJ |
NPI | 1023181252 |
---|---|
Provider Name | Mrs. Gabriella L D'ambrosio |
First Address | Burlington, NJ 08016-2250 |
Second Address | Burlington, NJ 08016-2250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |