Individual
NICOLE PHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
617 BROAD ST, NEWARK, NJ 07102-4403
(862) 246-7940
(862) 246-7941
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00434300
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2017
Last updated
08/07/2023
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