Individual
MR. WILSON SAMUEL GENAO-ESTEVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
134 EVERGREEN PL STE 501-10, EAST ORANGE, NJ 07018-2011
(908) 494-8886
Mailing address
466 CORNELL PL, HILLSIDE, NJ 07205-1747
(908) 494-8886
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
—
Other
Enumeration date
10/26/2023
Last updated
11/07/2023
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