Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 25MA11168500 | NJ |
NPI | 1063900579 |
---|---|
Provider Name | Avril A Ano |
First Address | Newark, NJ 07112-2027 |
Second Address | Newark, NJ 07112-2027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2018 |
Last Update Date | 01/12/2021 |