Individual
MR. ELIZARDO DOMINGO GUMABON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE
Contact information
Practice address
1098 WHITE OAK CT, TOMS RIVER, NJ 08753-5332
(732) 473-1569
(732) 473-9974
Mailing address
1098 WHITE OAK CT, TOMS RIVER, NJ 08753-5332
(732) 473-1569
(732) 473-9974
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NE01041700
NJ
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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