Individual
DEXTER MATA CALDONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 AYCRIGG AVE, PASSAIC, NJ 07055-5664
(973) 981-0476
Mailing address
39 AYCRIGG AVE, PASSAIC, NJ 07055-5664
(973) 981-0476
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00636200
NJ
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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