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Individual

JESSICA LILA IVAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RRT

Contact information

Practice address
300 MADISON AVE FL 3, MADISON, NJ 07940-1868
(973) 822-2772
Mailing address
146 WEISS TER, RARITAN, NJ 08869-1631
(908) 397-8242

Taxonomy

Speciality
Code
Description
License number
State
2279P1006X
Pulmonary Function Technologist Registered Respiratory Therapist
Primary
43ZA00512900
NJ

Other

Enumeration date
03/03/2022
Last updated
03/03/2022
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