Individual
RICHARD VALDERAS PENALOSA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 LOCUST ST, NEPTUNE, NJ 07753
(732) 447-6937
Mailing address
409 LOCUST ST, NEPTUNE, NJ 07753
(732) 447-6937
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ00853100
NJ
Other
Enumeration date
01/02/2019
Last updated
01/02/2019
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