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1396022562
JOSE LUIS MEDINA
BAYONNE, NJ
NPI
1396022562
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
Enumeration Date
2011-11-15
Last Update Date
2011-11-15
Business Address
-- JOSE LUIS MEDINA
106 W 53RD ST APT 26
BAYONNE, NJ 07002-3356
Phone number: 718-761-9800
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Mailing Address
-- JOSE LUIS MEDINA
106 W 53RD ST APT 26
BAYONNE, NJ 07002-3356
Phone number: 718-761-9800
Copy
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