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Individual

CAROL BACON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
201 LYONS AVE, NEWARK BETH ISRAEL MEDICAL CENTER, NEWARK, NJ 07112-2027
(973) 926-7320
(973) 705-8207
Mailing address
201 LYONS AVE, NEWARK BETH ISRAEL MEDICAL CENTER, NEWARK, NJ 07112-2027
(973) 926-7320
(973) 705-8207

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
26NJ00272500
NJ

Other

Enumeration date
04/12/2013
Last updated
04/12/2013
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