Individual
DAYSJIA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
135 1ST ST, HACKENSACK, NJ 07601-2423
(201) 646-7900
Mailing address
22 CRESCENT AVE, JERSEY CITY, NJ 07304-2812
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00250700
NJ
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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