Individual
NINA LOURDES EVANGELISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
194 2ND AVE, CEDAR GROVE, NJ 07009-1141
(973) 256-0330
(973) 812-0339
Mailing address
194 2ND AVE, CEDAR GROVE, NJ 07009-1141
(973) 256-0330
(973) 812-0339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA01223400
NJ
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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