Individual
EWA LOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
16 AVENUE B, BAYONNE, NJ 07002-1923
(201) 492-7793
Mailing address
16 AVENUE B, BAYONNE, NJ 07002-1923
(201) 492-7793
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00796900
NJ
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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