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Jason Bouziotis

Student in an Organized Health Care Education/Training Program in Vineland, NJ. Individual provider (NPI-1).

NPI number1164096236
StatusActive
Last updated in NPPESApr 12, 2024

Details

NPI
1164096236
Entity type
Individual (NPI-1)
Name
Jason Bouziotis
Sex
Male
Sole proprietor
No
Enumeration date
May 13, 2021
Certification date
Apr 12, 2024
Last updated
Apr 12, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

1505 W Sherman Ave
Vineland, NJ 08360-7059

Phone 856-641-8000

Mailing address

1505 W Sherman Ave
Vineland, NJ 08360-7059

Phone 856-641-8000

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