Individual
CLARENCE GOCON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
136 W SIDE AVE, JERSEY CITY, NJ 07305-1317
(201) 981-2633
Mailing address
136 W SIDE AVE, JERSEY CITY, NJ 07305-1317
(201) 981-2633
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ01079600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ01079600
NJ APN LICENSE
NJ
Enumeration date
11/20/2020
Last updated
11/20/2020
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