Organization
WOUND CARE SPECIALIST OF NEW JERSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANSEN MACALINDONG (CONSULTANT)
(917) 829-5301
Entity
Organization
Contact information
Practice address
824 KENNEDY BLVD., BAYONNE, NJ 07002-2212
(917) 829-5301
(888) 796-5637
Mailing address
824 KENNEDY BLVD, BAYONNE, NJ 07002-2872
(188) 796-5637
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
—
—
363L00000X
Nurse Practitioner
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
08/12/2010
Last updated
04/23/2011
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