Individual
GABRIELLA ALTAGRACIA GENAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 METRO BLVD, NUTLEY, NJ 07110-6101
(973) 275-2486
Mailing address
99 W MAPLE AVE, ALLENDALE, NJ 07401-1206
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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