Individual
KAITLYN CHERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 923-6522
Mailing address
3 CENTURY DR, PARSIPPANY, NJ 07054-4610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00314300
NJ
Other
Enumeration date
07/25/2013
Last updated
04/09/2014
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