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Individual

REAN EVANGELISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
5034 ATLANTIC AVE, MAYS LANDING, NJ 08330-2022
(609) 837-4600
Mailing address
324A S WILLOW AVE, GALLOWAY, NJ 08205-4662
(917) 819-9955

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP07875100
NJ

Other

Enumeration date
07/10/2023
Last updated
07/10/2023
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