Individual
MARIA MAMREGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 PINE HILL ST, JACKSON, NJ 08527-2414
(732) 796-5495
Mailing address
2 PINE HILL ST, JACKSON, NJ 08527-2414
(732) 796-5495
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
M03735196258712
NJ
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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