Provider Demographics
NPI:1174333199
Name:ANDUJAR, EFREN (LMT)
Entity type:Individual
Prefix:
First Name:EFREN
Middle Name:
Last Name:ANDUJAR
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 HACKENSACK ST # 2
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1413
Mailing Address - Country:US
Mailing Address - Phone:551-337-3349
Mailing Address - Fax:
Practice Address - Street 1:41 HACKENSACK ST # 2
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-1413
Practice Address - Country:US
Practice Address - Phone:551-337-3349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT01201900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist