Individual
GABRIEL MILGROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
730 PROSPECT ST, MAPLEWOOD, NJ 07040-3142
(800) 842-4663
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DI02890200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2021
Last updated
07/21/2022
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