Individual
JASON LOCICERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
14-00 BERDAN AVE, FAIR LAWN, NJ 07410-2155
(201) 794-5450
Mailing address
14-00 BERDAN AVE, FAIR LAWN, NJ 07410-2155
(201) 794-5450
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00059900
NJ
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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