Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | D510250 | NJ |
NPI | 1154387405 |
---|---|
Provider Name | Saul Weiner |
First Address | Newark, NJ 07101 |
Second Address | Newark, NJ 07101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 24/05/2013 |