Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | ZZD102055600 | NJ |
N | 208D00000X | General Practice Physician | ZSMA07810100 | NJ |
NPI | 1285707273 |
---|---|
Provider Name | Torin W Rutner |
First Address | Westfield, NJ 07090 |
Second Address | Westfield, NJ 07090-3312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 10/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V06252 | (02) |