Mackenzie Robert Livermore Valid NPI

Individual provider · Sports Medicine (Emergency Medicine) Physician · Rutherford, NJ

NPI

1356983787

Type

Individual (Type 1)

Primary specialty

Sports Medicine (Emergency Medicine) Physician (Emergency Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207PS0010X

License number

25MT00272900 (NJ)

Sex

Male

Sole proprietor

Yes

Enumerated

2019-10-17

Last updated

2019-10-17