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Individual

AMRO H DAFEELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
626 CENTRAL AVE STE 5, EAST ORANGE, NJ 07018-1438
(973) 395-2655
(973) 395-2665
Mailing address
71 S ORANGE AVE STE 117, SOUTH ORANGE, NJ 07079-1715
(973) 395-2655
(973) 395-2665

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26-3455033
MEDICAL TRANSPORTATION
NJ
Enumeration date
07/03/2018
Last updated
07/03/2018
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