Individual
KOSSIWA LAMENYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
99 RTE 37 W, TOMS RIVER, NJ 08755-6423
(800) 055-7732
Mailing address
99 RTE 37 W, TOMS RIVER, NJ 08755-6423
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00480500
NJ
Other
Enumeration date
06/20/2018
Last updated
05/09/2024
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