Individual
NICOLE LATONYA RAINEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1204 JAQUES AVE, RAHWAY, NJ 07065-3928
(908) 405-3411
Mailing address
1204 JAQUES AVE, RAHWAY, NJ 07065-3928
(908) 405-3411
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32WG06066900
NJ
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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