Individual
MR. MISAEL DIMATULAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
43 MAPLE DR, HAZLET, NJ 07730-1333
(646) 525-9621
Mailing address
43 MAPLE DR, HAZLET, NJ 07730-1333
(646) 525-9621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
343384
NY
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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