Individual
MS. JILLIAN LAGOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
901 W MAIN ST, FREEHOLD, NJ 07728-2537
(732) 294-2666
Mailing address
12 METEDECONK RD, HOWELL, NJ 07731-2928
(908) 692-6695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00307500
NJ
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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