Individual
DIANE MASTROLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1933 STATE ROUTE 35, SUITE 120, WALL TOWNSHIP, NJ 07719-3502
(732) 449-9503
Mailing address
1933 RT.35, SUITE 120, WALL, NJ 07719
(732) 449-9503
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3395
NJ
Other
Enumeration date
11/21/2006
Last updated
07/09/2007
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