Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 212534 | NY |
Y | 2082S0105X | Plastic Hand Surgeon | 25MA08986200 | NJ |
NPI | 1790855815 |
---|---|
Provider Name | Renata V Weber |
First Address | Rutherford, NJ 07070-2574 |
Second Address | Rutherford, NJ 07070-2574 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 27/05/2016 |