Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1353 | ME |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 202359 | NY |
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 25MB05620700 | NJ |
NPI | 1235361320 |
---|---|
Provider Name | Olha Sokhan |
First Address | Rutherford, NJ 07070-1651 |
Second Address | Rutherford, NJ 07070-1651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2009 |
Last Update Date | 21/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E 81980 | (02) |