Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | NJ |
NPI | 1003809609 |
---|---|
Provider Name | Ronald Barabas |
First Address | Wall Township, NJ 07719-9693 |
Second Address | Wall Township, NJ 07719-9693 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5448000 | (05) | NJ |