Individual
MR. BOEMBOY M VENDIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 HAMBURG TPKE STE 102, WAYNE, NJ 07470-2139
(201) 794-2121
Mailing address
432 CAMBRIDGE DR, BUTLER, NJ 07405-3242
(973) 462-8548
(201) 794-6003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01189500
NJ
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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