Individual
MR. JITHIN SAM EASO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
257 BRADLEY AVE, BERGENFIELD, NJ 07621-2226
(201) 244-5874
Mailing address
257 BRADLEY AVE, BERGENFIELD, NJ 07621-2226
(646) 853-1177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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