Provider Information for 1568906840
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NELLIE VIAL
Sex: Female
NPI: 1568906840
Last Updated: 2016-12-06
Certification Date:
Certification Date:
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NPI | 1568906840 | ||||||||
Enumeration Date | 2016-12-06 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 10 BROOK AVE BASKING RIDGE, NJ 07920-2002 United States Phone: | Fax: | ||||||||
Primary Practice Address | 248 COLUMBIA TPKE SUITE 210 FLORHAM PARK, NJ 07932-1210 United States Phone: 201-213-0050 | Fax: | ||||||||
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