Individual
BENJAMIN ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
124 WALTUMA AVE, EDISON, NJ 08837-2663
(732) 778-7351
Mailing address
124 WALTUMA AVE, EDISON, NJ 08837-2663
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/22/2023
Last updated
08/22/2023
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