Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 26NJ00745600 | NJ |
NPI | 1023533510 |
---|---|
Provider Name | Siddhita Parekh |
First Address | West Caldwell, NJ 07006-8031 |
Second Address | West Caldwell, NJ 07006-7457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2017 |
Last Update Date | 07/08/2017 |