Individual
ROMAN EVANGELISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6010 BLACK HORSE PIKE, EGG HARBOR TOWNSHIP, NJ 08234-9752
(609) 272-8580
(609) 272-8707
Mailing address
PO BOX 1086, PLEASANTVILLE, NJ 08232-6086
(609) 272-8580
(609) 272-8707
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/21/2008
Last updated
05/21/2008
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