Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jul 21, 2011
License(s)
26NJ00597900 (NJ)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 31 MEISTER ST | Somerset, NJ 08873-2140 | 908-636-3613 |
| LOCATION | 111 N ORANGE AVE STE 800 | Orlando, FL 32801-2381 | 888-731-8994 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.