Individual
MICHELLE NG-MADAYAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
120 FOWLER AVE, JERSEY CITY, NJ 07305-1910
(201) 721-5065
Mailing address
120 FOWLER AVE, JERSEY CITY, NJ 07305-1910
(201) 721-5065
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
26NR14416500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35-2321534
LUTHERAN SENIOR HEALTHCARE INC.
NJ
Enumeration date
09/10/2012
Last updated
09/10/2012
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