Individual
JACOB MANU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
85 MANOR DR, NEWARK, NJ 07106-3281
(862) 576-8553
Mailing address
85 MANOR DR, NEWARK, NJ 07106-3281
(862) 576-8553
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296356
NY
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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