Individual
AENOV LANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
104 14TH ST, CRESSKILL, NJ 07626-2408
(201) 266-8535
Mailing address
104 14TH ST, CRESSKILL, NJ 07626-2408
(201) 266-8535
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/08/2011
Last updated
07/08/2011
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