Individual
RENA AMBROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
255 BROAD ST, BLOOMFIELD, NJ 07003-2724
(973) 985-8392
Mailing address
255 BROAD ST, BLOOMFIELD, NJ 07003-2724
(973) 985-8392
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00272500
NJ
Other
Enumeration date
09/17/2014
Last updated
09/17/2014
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