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Individual

JOHANNA KUBICHEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
456 PROSPECT AVE, WEST ORANGE, NJ 07052-4112
(973) 731-6767
Mailing address
328 W SAINT GEORGES AVE, LINDEN, NJ 07036-5638
(908) 925-2273

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00407800
NJ

Other

Enumeration date
09/13/2016
Last updated
05/12/2021
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