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Individual

JOBECCA AVANZADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
127 OLD SHORT HILLS RD, WEST ORANGE, NJ 07052-1014
(908) 522-0000
Mailing address
127 OLD SHORT HILLS RD APT 213, WEST ORANGE, NJ 07052-1065

Taxonomy

Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10001000
PRIVATE
Enumeration date
12/27/2013
Last updated
04/28/2014
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