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Individual

MICHAEL FACCIOLLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RNFA

Contact information

Practice address
2208 3RD AVE, TOMS RIVER, NJ 08753-6016
(805) 709-3477
Mailing address
2208 3RD AVE, TOMS RIVER, NJ 08753-6016

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
26NR10692900
NJ

Other

Enumeration date
04/14/2009
Last updated
04/14/2009
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