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1992551139
SHANE PARK
NEWARK, NJ
NPI
1992551139
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-29
Last Update Date
2024-04-29
Business Address
SHANE PARK
110 BERGEN ST
NEWARK, NJ 07103-2495
Phone number: 973-972-4620
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Mailing Address
SHANE PARK
110 BERGEN ST
NEWARK, NJ 07103-2495
Phone number: 973-972-4620
Copy
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