Individual
MARCELLA MILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
695 S 18TH ST, NEWARK, NJ 07103-1053
(646) 861-9645
Mailing address
695 S 18TH ST, NEWARK, NJ 07103-1053
(646) 861-9645
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
260137
NY
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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