Individual
MARY E BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
514 AZALEA DR, BRICK, NJ 08724-2732
(732) 267-0852
(732) 903-6081
Mailing address
514 AZALEA DR, BRICK, NJ 08724-2732
(732) 267-0852
(732) 903-6081
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA00097700
NJ
Other
Enumeration date
06/09/2008
Last updated
11/12/2015
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