Individual
TYEISHA M BOYD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
621 S 20TH ST, UNIT 2, NEWARK, NJ 07103
(862) 202-9909
Mailing address
621 S 20TH ST, UNIT 2, NEWARK, NJ 07103
(862) 202-9909
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
NJ
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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