Individual
EDITH MAULTSBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
114 NEWARK WAY, MAPLEWOOD, NJ 07040-3327
(973) 979-5837
Mailing address
114 NEWARK WAY, MAPLEWOOD, NJ 07040-3327
(973) 979-5837
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
293055
NY
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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