SHAZAM BACCHUS

NEWARK, NJ
NPI1972133254
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner, Primary Care
(Licence: NJ  26NJ01004000)
Enumeration Date2020-01-24
Last Update Date2020-01-24
Business Address
SHAZAM BACCHUS APN
459 N 7TH ST FL 1
NEWARK, NJ 07107-3743
Phone number: 973-388-9560
Mailing Address
SHAZAM BACCHUS APN
459 N 7TH ST FL 1
NEWARK, NJ 07107-3743
Phone number: 973-388-9560
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