Individual
LORI MIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
89 WOODBINE AVE, AVENEL, NJ 07001-1003
(732) 602-8524
Mailing address
89 WOODBINE AVE, AVENEL, NJ 07001-1003
(732) 602-8524
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00023800
NJ
Other
Enumeration date
05/22/2007
Last updated
03/19/2008
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