Individual
UCHE IHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
642 EAGLE ROCK AVE, SUITE 3, WEST ORANGE, NJ 07052-2954
(201) 563-8916
(908) 756-5849
Mailing address
642 EAGLE ROCK AVE, SUITE 3, WEST ORANGE, NJ 07052-2954
(201) 563-8916
(908) 756-5849
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HPO113700
NJ
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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