NPI 1174539944

Roger Lee Gully, CERTIFIEDREHABTHER

Practitioner Rehabilitation Practitioner Clifton, NJ

Practice location

Address: 62 Fairmount Ave, Clifton, NJ 07011-3007
Phone: (973) 340-0890

Registered specialties

Rehabilitation Practitioner Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225400000X Licence 26BT00004800 (NJ)

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Registry record

NPI: 1174539944
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jul 2006
Record last updated: 8 Jul 2007

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.