Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 25MA06400400 | NJ |
NPI | 1518908268 |
---|---|
Provider Name | Roberto V Nachajon |
First Address | Paterson, NJ 07503-2621 |
Second Address | Paterson, NJ 07503-2621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7082908 | (05) | NJ |
G35608 | (02) |