NPI 1184116659

David James Antonini

Practitioner Supports Brokerage Agency Audubon, NJ

Practice location

Address: 100 Oswego Ave, Audubon, NJ 08106-2051
Phone: (856) 209-9109

Registered specialties

Supports Brokerage Agency Primary

Agencies Taxonomy 251X00000X Licence 1652154 (NJ)

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Registry record

NPI: 1184116659
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 May 2018
Record last updated: 31 May 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.