| NPI | 1235164583 |
|---|---|
| Former Name | PHYLLIS KOVALESKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NJ 26NJ00008200) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NJ NJ000082) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-10-29 |