Provider Information for 1992241350
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ELIZABETH BATES
Sex: Female
NPI: 1992241350
Last Updated: 2017-01-10
Certification Date:
Certification Date:
Details
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NPI | 1992241350 | ||||||||
Enumeration Date | 2017-01-10 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 3 SOUTHERN DR TINTON FALLS, NJ 07724-3166 United States Phone: 732-739-7939 | Fax: | ||||||||
Primary Practice Address | 216 MAPLE AVE SUITE 203 RED BANK, NJ 07701-1731 United States Phone: 732-739-7939 | Fax: | ||||||||
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