Individual
DOMINIC GIBILISCO-ZYKORIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9 TANNER ST STE 103, HADDONFIELD, NJ 08033-2432
(856) 492-4500
Mailing address
188 PERRY AVE, MOORESTOWN, NJ 08057-1846
(732) 770-9291
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
26NR11987500
NJ
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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