Individual
RAYMOND N. DIVIRGILIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 MORRIS AVE, UNION, NJ 07083-7133
(908) 737-0663
Mailing address
119 GLENWOOD RD, FANWOOD, NJ 07023-1474
(908) 737-0663
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00031600
NJ
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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