Individual
DANICA CAMILLE PANGANDOYON MENCHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
116-130 BROADWAY, PASSAIC, NJ 07055
(973) 779-2865
Mailing address
116-130 BROADWAY, PASSAIC, NJ 07055
(973) 799-2865
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
26NR20210400
NJ
163WS0200X
School Registered Nurse
7660341
NY
Other
Enumeration date
07/22/2019
Last updated
03/01/2022
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