Individual
JAYME KACZANOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
91 S ORANGE AVE, LIVINGSTON, NJ 07039-4901
(973) 992-7000
Mailing address
19 HUGHES PL, APT B, SUMMIT, NJ 07901-3341
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00140900
NJ
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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