Individual
MACKENZIE ROBERT LIVERMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 FELICIAN WAY, RUTHERFORD, NJ 07070-1977
(908) 752-7127
Mailing address
9 HOOK DR, MILFORD, NJ 08848-1539
Taxonomy
Speciality
Code
Description
License number
State
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
25MT00272900
NJ
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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