Individual
LUIS GINO PRADA GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN, FNP-BC
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-5123
Mailing address
150 BERGEN ST, NEWARK, NJ 07103-2496
(929) 428-5444
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ01377500
NJ
363LF0000X
Family Nurse Practitioner
APRN11020245
FL
Other
Enumeration date
06/22/2022
Last updated
01/31/2023
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