Individual
MISS ZHANNA RADEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
172 PALISADE AVE, BOGOTA, NJ 07603
(201) 880-5188
Mailing address
172 PALISADE AVE, BOGOTA, NJ 07603-1634
(201) 820-4365
(201) 820-4365
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
NY
Other
Enumeration date
04/19/2017
Last updated
04/19/2017
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