Individual
TIFFANY E GARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
193 TERRILL RD # 9, FANWOOD, NJ 07023-1018
(973) 380-9902
Mailing address
193 TERRILL RD # 9, FANWOOD, NJ 07023-1018
(973) 380-9902
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NJ
Other
Enumeration date
02/03/2018
Last updated
02/03/2018
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