Individual
CEIDA QUISPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
26 BALDWIN ST, EAST ORANGE, NJ 07017-1302
(973) 672-1212
Mailing address
625 LEGION CT, BOUND BROOK, NJ 08805-1109
(908) 230-5176
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00921600
NJ
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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