Individual
BRANT V NAVOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
23659 COLUMBUS RD, SUITE 3, COLUMBUS, NJ 08022-1979
(609) 324-1200
(609) 324-1444
Mailing address
127 ARK RD, STE 23, MOUNT LAUREL, NJ 08054-6304
(609) 324-1200
(609) 324-1444
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
40QA01230600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
900148721
GOUP TAX ID
NJ
Enumeration date
07/06/2007
Last updated
10/18/2017
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