Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 25MA04435400 | NJ |
NPI | 1407914633 |
---|---|
Provider Name | Nelson L. Turcios |
First Address | Somerville, NJ 08876-3006 |
Second Address | East Brunswick, NJ 08816-5405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 22/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
25MA04435400 | LICENSE (01) | NJ |
4004001 | (05) | NJ |
C62950 | (02) |