Individual
CHAYA BACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
750 N BROAD ST APT 1J, ELIZABETH, NJ 07208-2423
(732) 267-3988
Mailing address
750 N BROAD ST APT 1J, ELIZABETH, NJ 07208-2423
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
636800
NY
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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