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Individual

STEPHANE MYRTELE LAGUERRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
275 GREENBROOK RD, GREEN BROOK, NJ 08812-2223
(732) 968-6000
Mailing address
33 MOUNTAIN WAY, WEST ORANGE, NJ 07052-3737
(347) 276-4930

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
26NJ00706000
NJ

Other

Enumeration date
04/16/2017
Last updated
04/16/2017
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