Individual
MITAEC SUH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
20 POINT VIEW PKWY, WAYNE, NJ 07470-2057
(973) 628-8500
Mailing address
33 LENOX AVE, CLIFTON, NJ 07012-1818
(973) 779-5478
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00038400
NJ
Other
Enumeration date
05/27/2006
Last updated
07/08/2007
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