Individual
TSR JAMAAL MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2581 ELEANOR TERRACE, UNION, NJ 07083
(908) 967-4931
Mailing address
2581 ELEANOR TERRACE, UNION, NJ 07083
(908) 967-4931
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MT00191800
NJ
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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