Individual
LATRESE FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
12 SCHMITT ST, SAYREVILLE, NJ 08872-1261
(201) 780-2965
Mailing address
12 SCHMITT ST, SAYREVILLE, NJ 08872-1261
(201) 780-2965
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01166800
NJ
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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