Individual
NEBULON AZU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 JOHNSON RD, SOMERSET, NJ 08873-2930
(732) 246-2220
(732) 246-2220
Mailing address
20 JOHNSON RD, SOMERSET, NJ 08873-2930
(732) 246-2220
(732) 246-2220
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172A00000X
Driver
A97615840008602
NJ
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343800000X
Secured Medical Transport (VAN)
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
347E00000X
Transportation Broker
—
—
Other
Enumeration date
09/30/2015
Last updated
05/15/2016
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