Individual
IAN TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1945 NJ-33, NEPTUNE, NJ 07753
(732) 775-5500
Mailing address
1142 KENTON DR, TOMS RIVER, NJ 08753-3072
(516) 669-6366
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ14958500
NJ
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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