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Individual

ELLEN ENGEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
213 2ND AVE APT B7, ASBURY PARK, NJ 07712-6227
(732) 800-2204
Mailing address
213 2ND AVE APT B7, ASBURY PARK, NJ 07712-6227
(732) 800-2204

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT01364300
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
E59152137454942
MOTOR VEHICLE COMMISSION
NJ
Enumeration date
04/25/2020
Last updated
04/25/2020
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