Individual
GIFTY BOATEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3505 VILLAGE DR, AVENEL, NJ 07001-1064
(917) 407-3447
Mailing address
3505 VILLAGE DRIVE, AVENEL, NJ 07001
(917) 407-3447
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307198
NY
Other
Enumeration date
01/27/2016
Last updated
01/27/2016
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