Individual
DIRKSEN J. TAGUIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APN-C
Contact information
Practice address
210 JACK MARTIN BLVD STE D-1, BRICK, NJ 08724-7771
(732) 458-5854
(732) 458-8012
Mailing address
210 JACK MARTIN BLVD STE D-1, BRICK, NJ 08724-7771
(732) 458-5854
(732) 458-8012
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00885000
NJ
Other
Enumeration date
12/16/2018
Last updated
12/23/2019
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