Individual
ALATHEA WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
445 CENTRAL AVE APT B12, ORANGE, NJ 07050-2556
(908) 235-9499
Mailing address
445 CENTRAL AVE APT B12, ORANGE, NJ 07050-2556
(908) 235-9499
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
318702
NY
Other
Enumeration date
01/31/2015
Last updated
01/31/2015
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