Individual
MRS. MARY ELIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 BERGEN ST, NEWARK, NJ 07103-2425
(973) 972-2479
Mailing address
140 BERGEN ST, NEWARK, NJ 07103-2425
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NR13849900
NJ
Other
Enumeration date
03/22/2019
Last updated
03/22/2019
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