Individual
MICHAEL MONGIELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
355 GRAND ST, JERSEY CITY, NJ 07302-4321
(201) 915-2000
Mailing address
234 SUYDAM AVE APT 502, JERSEY CITY, NJ 07304-3387
(215) 678-6956
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR13910400
NJ
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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