Individual
MIATA CLAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
708 SEAPORT DR APT A, ELIZABETH, NJ 07201-3385
(917) 485-4426
Mailing address
708 SEAPORT DR APT A, ELIZABETH, NJ 07201-3385
(917) 485-4426
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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