Individual
SELAMI KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 LAUREL ST, CARTERET, NJ 07008-2447
(732) 877-9654
Mailing address
55 LAUREL ST, CARTERET, NJ 07008-2447
(732) 877-9654
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
26NJ01342400
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01342400
NJ
Other
Enumeration date
07/12/2022
Last updated
04/23/2024
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