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Individual

JENNIFER DEMOSTHENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
166 LYONS AVE, NEWARK, NJ 07112-2016
(973) 926-8491
Mailing address
166 LYONS AVE, NEWARK, NJ 07112-2016
(973) 926-8491

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NR20660900
NJ
363L00000X
Nurse Practitioner
Primary
26NJ01359200
NJ

Other

Enumeration date
06/23/2021
Last updated
05/07/2026
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