Individual
LINDA FAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
225 WILLIAMSON ST, ELIZABETH, NJ 07202-3625
(908) 994-5000
Mailing address
225 WILLIAMSON ST, ELIZABETH, NJ 07202-3625
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00658400
NJ
Other
Enumeration date
10/28/2021
Last updated
04/26/2024
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