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1932561875
BENJAMIN FAN
LAKE COMO, NJ
NPI
1932561875
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA01655100)
Enumeration Date
2016-03-21
Last Update Date
2016-03-21
Business Address
-- BENJAMIN FAN PT, DPT
1719 MAIN STREET
LAKE COMO, NJ 07719
Phone number: 732-894-9200
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Mailing Address
-- BENJAMIN FAN PT, DPT
16 OVERHILL ROAD
EAST BRUNSWICK, NJ 08816
Phone number: 732-543-4413
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