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Individual

DR. EDWINA VERNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
86 S HARRISON ST, EAST ORANGE, NJ 07018-1704
(973) 414-1886
(973) 674-6134
Mailing address
PO BOX 3155, EAST ORANGE, NJ 07019-3155
(973) 414-1886

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
25MA03802100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1194996645
444 WILLIAM STREET
NJ
05
1479407
NJ
01
15484310901
982 BROAD STREET
NJ
01
1740345693
741 BROADWAY
NM
01
1932370483
101 LUDLOW STREET
NJ
Enumeration date
05/16/2006
Last updated
06/03/2008
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