Individual
MS. FANIOLA JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
240 PARKWAY AVE, EWING, NJ 08618-2932
(347) 995-6976
Mailing address
240 PARKWAY AVE, EWING, NJ 08618-2932
(347) 995-6976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
626136-1
NY
Other
Enumeration date
02/02/2014
Last updated
02/02/2014
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