Individual
BONNIE ANNE NEZLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 CENTRAL AVE, NEW PROVIDENCE, NJ 07974-1505
(908) 522-2215
(908) 522-0764
Mailing address
550 CENTRAL AVE, NEW PROVIDENCE, NJ 07974-1505
(908) 522-2215
(908) 522-0764
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00624200
NJ
235Z00000X
Speech-Language Pathologist
41YS00928700
NJ
Other
Enumeration date
04/01/2020
Last updated
04/01/2020
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