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General NPI Number Information
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NPI Number | 1710922547
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Entity Type | Individual
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Provider Name | MARIA LINDA HONORIO ATC
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Gender | Female
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 80 LOCK ST
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City | NEWARK
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State | NJ
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Zip | 07103-3507
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Country | US
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Telephone | 973-596-3623
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Fax |
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Provider Business Mailing Address
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Address Line | 1939 AXTON AVE
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City | UNION
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State | NJ
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Zip | 07083-6148
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Country | US
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Telephone | 856-313-0867
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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