Individual
PIUS ILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1480 US HIGHWAY 46 APT 174A, PARSIPPANY, NJ 07054-5911
(201) 270-6792
Mailing address
1480 US HIGHWAY 46 APT 174A, PARSIPPANY, NJ 07054-5911
(201) 270-6792
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00660200
NJ
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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