Individual
BLADDYMIR CORONEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
258 ANDREW PL, BLOOMINGDALE, NJ 07403-1524
(201) 704-8134
Mailing address
258 ANDREW PL, BLOOMINGDALE, NJ 07403-1524
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
QA00467400
NJ
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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