Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MB 15540 | NJ |
NPI | 1043326994 |
---|---|
Provider Name | Norman Hope Ilowite |
First Address | Fort Lee, NJ 07024 |
Second Address | Fort Lee, NJ 07024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E06189 | (02) |