Individual
VIRGINIA TINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4 JEROME CT, BELLEVILLE, NJ 07109-1359
(973) 557-8285
Mailing address
4 JEROME CT, BELLEVILLE, NJ 07109-1652
(973) 557-8285
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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