Individual
AL-JATHIYAH BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 KINGSLAND ST, NUTLEY, NJ 07110-1150
(973) 761-9306
Mailing address
340 KINGSLAND ST, NUTLEY, NJ 07110-1150
(973) 761-9306
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/25/2025
Last updated
08/25/2025
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