Individual
MR. REY MOISES FAJARDO VITUG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
560 BERKELEY AVE, ORANGE, NJ 07050-2109
(973) 672-6500
Mailing address
9 TOWERS ST, JERSEY CITY, NJ 07305-1004
(201) 333-8987
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
40QB00194900
NJ
Other
Enumeration date
03/31/2008
Last updated
09/20/2011
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