Individual
MAURICIO CACERES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 SYCAMORE RD, BAYONNE, NJ 07002-2224
(201) 360-1240
Mailing address
100 MONTGOMERY ST APT 2K, JERSEY CITY, NJ 07302-3733
(551) 795-4801
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP06827000
NJ
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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