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1831901578
MOISES EMMANUEL AZCONA
BOUND BROOK, NJ
NPI
1831901578
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NJ 25mt00303300)
Enumeration Date
2025-01-21
Last Update Date
2025-01-21
Business Address
MOISES EMMANUEL AZCONA
111 W UNION AVE
BOUND BROOK, NJ 08805-1396
Phone number: 908-986-8310
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Mailing Address
MOISES EMMANUEL AZCONA
1524 MAPLE AVE
HILLSIDE, NJ 07205-1511
Phone number: 908-986-8310
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