Individual
MARIA LOURDES JOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 NEWARK AVE, ELIZABETH, NJ 07208-3539
(908) 353-7443
Mailing address
72 GRIECO DR, JERSEY CITY, NJ 07305-4898
(201) 433-8568
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
28RI03409900
NJ
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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