Individual
EDITA SURBLIENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
123 FRANKLIN CORNER RD STE 106, LAWRENCEVILLE, NJ 08648-2526
(609) 896-2505
Mailing address
123 FRANKLIN CORNER RD STE 106, LAWRENCEVILLE, NJ 08648-2526
(609) 896-2505
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26NJ01228700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ01228700
APN NURSING LICENSE
NJ
01
—
P01187400
STATE CDS
NJ
Enumeration date
12/21/2021
Last updated
12/21/2021
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