Individual
MINI OOMMEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5000
Mailing address
94 OLD SHORT HILLS RD, LIVINGSTON, NJ 07039-5672
(973) 322-5000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ01179700
NJ
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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