Individual
MRS. ADENA TARA HOMNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-4900
(973) 972-7441
Mailing address
5 N CREST PL, LAKEWOOD, NJ 08701-2967
(732) 886-2997
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00034600
NJ
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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