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Individual

AMY CHURCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1 ROBERT WOOD JOHNSON PL, MEB 104, NEW BRUNSWICK, NJ 08903
(732) 235-8717
Mailing address
66 WEST GILBERT ST, RED BANK, NJ 07701
(732) 212-0051
(732) 212-0713

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
206943
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01780592
NY
Enumeration date
08/15/2005
Last updated
01/22/2008
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