NPI 1003323908

Raymond N. Divirgilio

Practitioner Athletic Trainer Union, NJ

Practice location

Address: 1000 Morris Ave, Union, NJ 07083-7133
Phone: (908) 737-0663
Mailing address: 119 Glenwood Rd, Fanwood, NJ 07023-1474

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 25MT00031600 (NJ)

Other Specialist/Technologist providers in New Jersey →

Registry record

NPI: 1003323908
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Jan 2018
Record last updated: 2 Jan 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.