MIYASARI RANOEWIDJOJO

HACKENSACK, NJ
NPI1033324645
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NJ  25MP00118300)
Enumeration Date2007-05-14
Last Update Date2007-12-13
Business Address
-- MIYASARI RANOEWIDJOJO PA C
30 PROSPECT AVE HACKENSACK UNIVERSITY MEDICAL CENTER
HACKENSACK, NJ 07601-1914
Phone number: 201-996-4614
Mailing Address
-- MIYASARI RANOEWIDJOJO PA C
45 GENOBLE RD
MONTVILLE, NJ 07045
Phone number: 347-223-8788
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