Individual
JESUS ALBERTO MENDOZA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
141 BROUGHTON AVE, BLOOMFIELD, NJ 07003-3930
(862) 333-8800
Mailing address
141 BROUGHTON AVE, BLOOMFIELD, NJ 07003-3930
(862) 333-8800
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
M25164016101012
NJ
Other
Enumeration date
01/18/2021
Last updated
01/18/2021
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