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Individual

FAY CORRINE WILTSHIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
322 RYAN ST, HILLSIDE, NJ 07205-2128
(908) 355-0002
(908) 355-0015
Mailing address
322 RYAN ST, HILLSIDE, NJ 07205-2128
(908) 355-0002
(908) 355-0015

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
HP0299700
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
84-3890262
HOME CARE
NJ
Enumeration date
05/04/2020
Last updated
05/04/2020
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