Individual
MS. NANCY BRODERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
74 PASCACK RD STE 5, PARK RIDGE, NJ 07656-1941
(201) 323-1218
Mailing address
22 MONTVALE AVE, MONTVALE, NJ 07645-1425
(201) 323-1218
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01129500
NJ
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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