Individual
MRS. IMELDA DE VERA GUIMARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
268 MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-2011
(201) 512-9494
Mailing address
120 HILLSIDE AVE, NUTLEY, NJ 07110-1600
(862) 596-4300
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NJ000899
NJ
363L00000X
Nurse Practitioner
Primary
26NJ0008990
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221775306
—
NJ
05
—
6301703
—
NJ
Enumeration date
11/17/2006
Last updated
11/10/2023
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