Doctor Name: | DR. NANCY SIERRA |
NPI Number: | 1083609846 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 25MA05590000 |
Business Practice Address: | 268 Dr Martin Luther King Jr Blvd Newark, NJ - 071022011 |
Business Phone Number: | 9738775000 |
Business Fax Number: | |
Mailing Address: | 66 W Gilbert St, TINTON FALLS |
State: | NJ |
Postal Code: | 077014918 |
Phone Number: | 7322120060 |
Fax Number: | |
NPI Enumeration Date: | 09/16/2005 |
NPI Last Update Date: | 07/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA05590000 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |