Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NN09999000 | NJ |
NPI | 1427258029 |
---|---|
Provider Name | Ms. Geraldine Theresa Bowe |
First Address | Little Ferry, NJ 07643-1038 |
Second Address | Teaneck, NJ 07666-4242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 09/07/2010 |