Individual
ELIOT BANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 DALE DR, WEST ORANGE, NJ 07052-2005
(917) 902-0136
Mailing address
15 DALE DR, WEST ORANGE, NJ 07052-2005
(917) 902-0136
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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