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General NPI Number Information
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NPI Number | 1205573607
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Entity Type | Individual
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Provider Name | MOZARD JEAN-NOEL
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Gender | Male
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 2228 BALMORAL AVE
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City | UNION
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State | NJ
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Zip | 07083-5204
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Country | US
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Telephone | 973-715-3961
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Fax |
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Provider Business Mailing Address
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Address Line | 2228 BALMORAL AVE
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City | UNION
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State | NJ
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Zip | 07083-5204
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Country | US
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Telephone | 973-715-3961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 500-PA
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License Number State | PR
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