Individual
EMPRIS VANDIVIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
584 S 20TH ST, NEWARK, NJ 07103-1113
(973) 393-4344
Mailing address
584 S 20TH ST, NEWARK, NJ 07103-1113
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
26NP49553900
NJ
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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