Individual
MR. CLARVIN ALFONSO OMBAJIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
19-21 FAIR LAWN AVE, FAIR LAWN, NJ 07410-2331
(201) 796-7772
(201) 794-8818
Mailing address
15 DAPP CT, ELMWOOD PARK, NJ 07407-3301
(201) 281-5790
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA00995000
NJ
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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