Individual
MARIO GENCARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
188 RIDGEDALE AVE, CEDAR KNOLLS, NJ 07927-1811
(973) 951-3557
Mailing address
188 RIDGEDALE AVE, CEDAR KNOLLS, NJ 07927-1811
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00239500
NJ
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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