Individual
MOLY POULOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
880 RIVER RD, NEW MILFORD, NJ 07646-3097
(866) 389-2727
(201) 225-2106
Mailing address
880 RIVER RD, NEW MILFORD, NJ 07646-3097
(866) 389-2727
(201) 225-2106
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO10644300
NJ
163W00000X
Registered Nurse
488126
NY
363L00000X
Nurse Practitioner
F333216
NY
363LF0000X
Family Nurse Practitioner
Primary
26NN10644300
NJ
Other
Enumeration date
03/29/2007
Last updated
10/01/2016
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