Individual
MR. ENRIQUE D CHAPPILLIQUEN LUCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3916 KENNEDY BLVD, UNION CITY, NJ 07087-2608
(201) 624-1877
Mailing address
550 NEWARK AVE, SUITE 307, JERSEY CITY, NJ 07306-1326
(201) 418-0048
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00411000
NJ
Other
Enumeration date
09/29/2016
Last updated
09/29/2016
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