Individual
EDWIN J CUSTODIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
860 S WHITE HORSE PIKE, HAMMONTON, NJ 08037-2018
(609) 567-0200
(609) 567-1951
Mailing address
521 RICHARD DR, MILLVILLE, NJ 08332-4040
(856) 285-0841
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ15527500
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NR22177100
NJ
Other
Enumeration date
04/11/2025
Last updated
04/28/2026
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