Individual
NICKITA HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1199 PLEASANT VALLEY WAY, WEST ORANGE, NJ 07052-1424
(973) 414-4736
Mailing address
101 TELFORD ST, NEWARK, NJ 07106-1113
(973) 818-7814
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/22/2021
Last updated
01/22/2021
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