Individual
EDNA OBIETIALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 W RUNYON ST, NEWARK, NJ 07108-1705
(973) 818-3565
Mailing address
263 W RUNYON ST, NEWARK, NJ 07108-1705
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
740741
NY
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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