Individual
GINETTE ILLUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
167 AVENUE AT THE CMN, SHREWSBURY, NJ 07702-4805
(732) 389-2555
Mailing address
610 SEWALL AVE APT 7A, ASBURY PARK, NJ 07712-6544
(917) 843-1803
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
25MD00363100
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2018
Last updated
09/13/2021
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