Individual
MS. TERESA NICOLE FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
94 OLD SHORT HILLS ROAD, SAINT BARNABAS MEDICAL CENTER, LIVINGSTON, NJ 07039
(973) 322-5000
Mailing address
143 WEST 28TH STREET, BAYONNE, NJ 07002
(201) 339-4544
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00029500
NJ
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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