Individual
MIRIAM ENOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 S ORANGE AVE, SUITE A-1020, NEWARK, NJ 07103-2785
(973) 972-3066
Mailing address
205 S ORANGE AVE, SUITE A-1020, NEWARK, NJ 07103-2785
(973) 972-3066
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00368500
NJ
363AM0700X
Medical Physician Assistant
25MP00368500
NJ
363AS0400X
Surgical Physician Assistant
25MP00368500
NJ
Other
Enumeration date
10/09/2015
Last updated
02/15/2021
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