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Individual

AJAY S MAMPILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 KINDERKAMACK RD, EMERSON, NJ 07630-1828
(888) 493-6415
Mailing address
67 ROLLINSON ST, WEST ORANGE, NJ 07052-4625
(973) 517-2094

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00300600
NJ

Other

Enumeration date
08/22/2013
Last updated
08/22/2013
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