Individual
JONATHAN MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, MMP
Contact information
Practice address
15-01 POLLITT DR STE 3, FAIR LAWN, NJ 07410-2769
(201) 785-6792
Mailing address
291 VERNON AVE, PATERSON, NJ 07503-1010
(201) 785-6792
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00590100
NJ
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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