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Individual

MS. KEMPOLLY DATISHA SWABY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
531 LINCOLN AVE, ORANGE, NJ 07050-2122
(973) 941-6617
Mailing address
531 LINCOLN AVE, ORANGE, NJ 07050-2122
(973) 941-6617

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ01183500
NJ

Other

Enumeration date
08/13/2021
Last updated
08/17/2021
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