Individual
YELENA RAFAELOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 SARAH CT, LAKEWOOD, NJ 08701
(732) 995-9653
Mailing address
105 SARAH CT, LAKEWOOD, NJ 08701
(732) 995-9653
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00350000
NJ
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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