Individual
MR. GARY RUSSELL LOUIZIDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RNFA, SA-C
Contact information
Practice address
554 LINWOOD AVE, RIDGEWOOD, NJ 07450-3520
(201) 887-2030
Mailing address
554 LINWOOD AVE, RIDGEWOOD, NJ 07450-3520
(201) 887-2030
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
26NO11195600
NJ
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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