Registry details
Type
Individual
Primary specialty
Physician Assistant, Medical
Enumerated
Sep 22, 2018
License(s)
022635 (NY), 25MP00593300 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1 DIAMOND HILL RD | Berkeley Heights, NJ 07922-2104 | 908-273-4300 |
| LOCATION | 231 WASHINGTON ST | Hoboken, NJ 07030-7221 | 201-754-1006 |
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