Individual
KHALENA F ANSELMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 HIGHWAY 71 STE 2, SEA GIRT, NJ 08750-2805
(732) 974-8100
Mailing address
700 HIGHWAY 71 STE 2, SEA GIRT, NJ 08750-2805
(732) 974-8100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00460300
NJ
Other
Enumeration date
09/05/2013
Last updated
09/19/2013
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