Individual
KEVIN GAZZALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
645 ROUTE 18, EAST BRUNSWICK, NJ 08816-3760
(732) 390-1160
Mailing address
645 ROUTE 18, EAST BRUNSWICK, NJ 08816-3760
(908) 705-3746
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00835600
NJ
Other
Enumeration date
02/19/2024
Last updated
05/20/2024
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