Individual
DR. ESIRA JAIMIE BEAUBRUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
323 BELLEVILLE AVE FL 2, BLOOMFIELD, NJ 07003-3648
(973) 842-4272
(732) 997-3022
Mailing address
323 BELLEVILLE AVE FL 2, BLOOMFIELD, NJ 07003-3648
(973) 842-4272
(732) 997-3022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA09780500
NJ
390200000X
Student in an Organized Health Care Education/Training Program
25MA09780500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0532584
—
NJ
Enumeration date
05/11/2012
Last updated
11/30/2017
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