Organization
MICHELE ISAACS GLIKSMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIONA MACK (ADMINISTRATIVE MEDICAL ASSISTANT)
(201) 384-8310
Entity
Organization
Contact information
Practice address
155 N WASHINGTON AVE, BERGENFIELD, NJ 07621-1742
(201) 384-8310
(201) 384-1085
Mailing address
155 N WASHINGTON AVE, BERGENFIELD, NJ 07621-1742
(201) 384-8310
(201) 384-1085
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
25MA06064200
NJ
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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