Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 25MA07294500 | NJ |
NPI | 1023193000 |
---|---|
Provider Name | Nasrin Ghesani |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103-2496 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 20/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8720606 | (05) | NJ |
H53492 | (02) |