Individual
DIVYA MADAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 AVENUE C, BAYONNE, NJ 07002-3012
(201) 339-2225
Mailing address
106 MERRYWOOD DR, EDISON, NJ 08817-2505
(732) 666-7722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
034823
NY
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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