Individual
PRECIOUS 134-04-9109 NWIGWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1042 JOHN GLENN DR, HILLSIDE, NJ 07205-2743
(908) 906-3491
Mailing address
1042 JOHN GLENN DR, HILLSIDE, NJ 07205-2743
(908) 906-3491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
795333
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
795333
—
NY
Enumeration date
08/19/2022
Last updated
08/19/2022
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