Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 25MA08490600 | NJ |
NPI | 1104967488 |
---|---|
Provider Name | Padam K Neopane |
First Address | Baltimore, MD 21228-4873 |
Second Address | Pompton Plains, NJ 07444-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 06/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0206385 | (05) | NJ |