Individual
DIANE ANDREA ELVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
62 EUCLID AVE, HACKENSACK, NJ 07601-4510
(201) 820-3001
Mailing address
62 EUCLID AVE, HACKENSACK, NJ 07601-4510
(201) 820-3001
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296741
NJ
Other
Enumeration date
05/14/2009
Last updated
05/14/2009
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