Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 25MD00273900 | NJ |
NPI | 1053355503 |
---|---|
Provider Name | Wendy K Stinson |
First Address | Belleville, NJ 07109-1968 |
Second Address | Cedar Knolls, NJ 07927-2109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 13/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BS2855522 | DEA (01) | NJ |
D08334300 | CDS LICENSE (01) | NJ |
U38028 | (02) | NJ |