Individual
DR. DARA KRISTEN SELENE QUERIMIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
460 BLOOMFIELD AVE, SUITE 400, MONTCLAIR, NJ 07042-3582
(973) 704-9222
Mailing address
86 GROVE ST UNIT 2, UNIT 2, MONTCLAIR, NJ 07042-3708
(973) 704-9222
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4769
NJ
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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