Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Sep 13, 2012
License(s)
25MP00627600 (NJ), 015909 (NY)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1 DIAMOND HILL RD | Berkeley Heights, NJ 07922-2104 | 908-273-4300 |
| LOCATION | 852 ROUTE 3 | Clifton, NJ 07012-2343 | 973-450-1991 |
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