Individual
NENA L SY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-4300
Mailing address
PO BOX 343, MIDLAND PARK, NJ 07432-0343
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 26735
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2838303
—
NJ
Enumeration date
05/23/2005
Last updated
07/27/2007
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