Individual
DANIEL ROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
147 HOBART STREET, RIDGIEFIEL PARK, NJ 07660
(917) 736-5332
Mailing address
147 HOBART ST, RIDGEFIELD PARK, NJ 07660-1806
(917) 736-5332
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
664091
NY
Other
Enumeration date
03/19/2013
Last updated
01/24/2014
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