Individual
GUTEMBERG CHARLES-SAINT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1500 ROUTE 88, BRICK, NJ 08724-2320
(732) 458-1700
Mailing address
1500 ROUTE 88, BRICK, NJ 08724-2320
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP07141500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0029807
—
NJ
Enumeration date
06/27/2014
Last updated
06/27/2014
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