Individual
ISI IGIEBOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 LARK DR, SOUTH RIVER, NJ 08882-2605
(848) 203-2949
Mailing address
27 LARK DR, SOUTH RIVER, NJ 08882-2605
(848) 203-2949
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
NJ
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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