Individual
JOAN RUTH ESPERANZA MANGLICMOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
30 PROSPECT AVE, 3RD FLOOR MAIN BUILDING ROOM 3627, HACKENSACK, NJ 07601-1915
(551) 996-2331
Mailing address
30 PROSPECT AVE, 3RD FLOOR MAIN BUILDING ROOM 3627, HACKENSACK, NJ 07601-1915
(551) 996-2331
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/07/2016
Last updated
12/17/2021
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