Individual
MAIKEL HERRERA YNFIESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
355 GRAND ST, JERSEY CITY, NJ 07302-4321
(201) 915-2000
Mailing address
420 LIVINGSTON ST, ELIZABETH, NJ 07206-1322
(917) 392-5057
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ01056600
NJ
363LG0600X
Gerontology Nurse Practitioner
26NJ01056600
NJ
Other
Enumeration date
09/30/2020
Last updated
04/17/2024
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