Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA04209200 | NJ |
N | 207RI0011X | Interventional Cardiology | 25MA04209200 | NJ |
NPI | 1003814039 |
---|---|
Provider Name | Richard I Watson |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6440 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 02/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1742906 | (05) | NJ |
D90405 | (02) |