Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 25MA07215900 | NJ |
NPI | 1205905031 |
---|---|
Provider Name | Ziad C. Sifri |
First Address | Newark, NJ 07107-3000 |
Second Address | Newark, NJ 07103-2496 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 21/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9117407 | (05) | NJ |
H89519 | (02) | NJ |