Individual
MR. MARVIN BASILIO AZARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1914
(201) 996-2816
(201) 343-9823
Mailing address
142 ETHEL AVE, HAWTHORNE, NJ 07506-1527
(321) 276-4310
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00294900
NJ
Other
Enumeration date
09/30/2010
Last updated
09/30/2010
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