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Individual

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Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
395 DANFORTH AVE, JERSEY CITY, NJ 07305-1975
(201) 200-9801
(201) 324-0735
Mailing address
395 DANFORTH AVE, JERSEY CITY, NJ 07305-1975
(201) 200-9801

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP06173300
NJ

Other

Enumeration date
05/08/2023
Last updated
05/08/2023
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