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Individual

MS. EBONI K GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
240 MULBERRY ST, NEWARK, NJ 07102-3528
(973) 622-3900
Mailing address
240 MULBERRY ST, NEWARK, NJ 07102-3528
(973) 622-3900

Taxonomy

Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
26NJ15117700
NJ
363LW0102X
Women's Health Nurse Practitioner
Primary
26NJ15117700
NJ
363LW0102X
Women's Health Nurse Practitioner
421600
NY

Other

Enumeration date
03/03/2023
Last updated
05/13/2026
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