Doctor Name: | MRS. MARY ELLEN BOWES |
NPI Number: | 1518136530 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 25MA02025400 |
Business Practice Address: | 1455 Woodacres Dr Mountainside, NJ - 070921738 |
Business Phone Number: | 9082337289 |
Business Fax Number: | 9082331465 |
Mailing Address: | 1455 Woodacres Dr, MOUNTAINSIDE |
State: | NJ |
Postal Code: | 070921738 |
Phone Number: | 9082337289 |
Fax Number: | 9082331465 |
NPI Enumeration Date: | 02/24/2008 |
NPI Last Update Date: | 02/24/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA02025400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |