Individual
MICHELE GILLILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
140 BERGEN ST # STREETD, NEWARK, NJ 07103-2425
(973) 972-2076
(972) 972-1080
Mailing address
140 BERGEN ST # STREETD, NEWARK, NJ 07103-2425
(973) 972-2076
(972) 972-1080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00089400
NJ
Other
Enumeration date
05/21/2007
Last updated
02/02/2021
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