Individual
MARTHIN MAVERICK CORONADO SALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9 MULE RD STE E5, TOMS RIVER, NJ 08755-5052
(732) 230-2661
Mailing address
1155 CATTUS ISLAND BLVD, TOMS RIVER, NJ 08753-3908
(732) 485-2210
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ01368700
NJ
Other
Enumeration date
09/16/2022
Last updated
02/26/2023
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