Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MA32093 | NJ |
NPI | 1093759003 |
---|---|
Provider Name | Richard Lander |
First Address | Livingston, NJ 07039-3648 |
Second Address | Livingston, NJ 07039-3648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 08/07/2007 |