Individual
LINA MARIA JIMENEZ MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1009 76TH ST, NORTH BERGEN, NJ 07047-4913
(201) 344-9537
Mailing address
1009 76TH ST, NORTH BERGEN, NJ 07047-4913
(201) 344-9537
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
338159
NY
164W00000X
Licensed Practical Nurse
NJDCATEMP-018577
NJ
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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