Individual
MICHAEL MAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 POCONO RD, DENVILLE, NJ 07834-2954
(973) 625-5000
Mailing address
1101 ADAMS ST APT 406, HOBOKEN, NJ 07030-2221
(201) 963-9211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MP-529
NJ
Other
Enumeration date
10/20/2006
Last updated
07/08/2007
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