Individual
SUPREMA DANCEL NAIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
148 8TH ST., PASSAIC, NJ 07055
(973) 470-3000
Mailing address
23 HOPPER LN, WAYNE, NJ 07470-4656
(973) 694-2810
(973) 694-2810
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MAO63245
NJ
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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