Individual
MRS. YURATA GERWEL MODZELEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
105 POWERVILLE ROAD, BOONTON TWP, NJ 07005
(973) 299-2903
(973) 299-2903
Mailing address
105 POWERVILLE ROAD, BOONTON TWP, NJ 07005
(973) 299-2903
(973) 299-2903
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA03879000
NJ
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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