Individual
HICKSON PAUL KORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
115B MACARTHUR AVE, GARFIELD, NJ 07026-1577
(201) 417-8637
Mailing address
115B MACARTHUR AVE, GARFIELD, NJ 07026-1577
(201) 417-8637
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
307206
NY
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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