Individual
CARMELIZA RONQUILLO GONZALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
836 WILLIAMS AVENUE, TEANECK, NJ 07666
(201) 282-7848
Mailing address
836 WILLIAMS AVE, TEANECK, NJ 07666-2518
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1342256
—
NY
Enumeration date
06/08/2017
Last updated
06/08/2017
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