Individual
MISS LUCKNIE OVINCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
50 NEWARK AVE, BELLEVILLE, NJ 07109-1185
(973) 751-2060
Mailing address
245 S BURNETT ST, EAST ORANGE, NJ 07018-2502
(862) 452-7882
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00297800
NJ
Other
Enumeration date
05/09/2013
Last updated
05/09/2013
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