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Individual

MS. JERRICA TUBALADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3107 JFK BLVD, NORTH BERGEN, NJ 07047
(201) 866-2800
Mailing address
3107 KENNEDY BLVD FL 1, NORTH BERGEN, NJ 07047-2378
(201) 866-2800

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
014253
NY
225200000X
Physical Therapy Assistant
Primary
40QB00414100
NJ

Other

Enumeration date
05/10/2024
Last updated
09/06/2024
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