Individual
PRUDENCE C NWOBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 W KINNEY ST, NEWARK, NJ 07102-1104
(862) 755-3118
Mailing address
72 W KINNEY ST, NEWARK, NJ 07102-1104
(862) 755-3118
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
283842
NY
Other
Enumeration date
02/24/2012
Last updated
02/24/2012
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