Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MA68023 | NJ |
NPI | 1992707863 |
---|---|
Provider Name | Dr. John D Cunningham |
First Address | Berkeley Heights, NJ 07922-2104 |
Second Address | Berkeley Heights, NJ 07922-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 31/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D96430 | (02) | NJ |