Individual
MRS. KATI DAGHESTANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
109 VALLEY RD, MONTCLAIR, NJ 07042-2322
(973) 655-9662
Mailing address
353 DIAMOND BRIDGE AVE, HAWTHORNE, NJ 07506-1325
(973) 908-7548
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15093000
NJ
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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