Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | MA0803900 | NJ |
NPI | 1326060740 |
---|---|
Provider Name | Yongming Mao |
First Address | Brooklyn, NY 11220-3677 |
Second Address | Edison, NJ 08820-3947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 10/09/2018 |