Individual
BEVERLEY MARIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
765 VOSE AVE, UNIT B10, ORANGE, NJ 07050-1060
(973) 677-9711
Mailing address
765 VOSE AVE, UNIT B10, ORANGE, NJ 07050-1060
(973) 677-9711
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280338-1
NY
Other
Enumeration date
02/19/2010
Last updated
11/01/2010
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