Healthcare Provider Details

I. General information

NPI: 1912595513
Provider Name (Legal Business Name): GLADYS M ZOKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2021
Last Update Date: 01/08/2021
Certification Date: 01/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 MOUNT AIRY RD STE 100
BASKING RIDGE NJ
07920-2338
US

IV. Provider business mailing address

3 STANFORD DR APT 1B
BRIDGEWATER NJ
08807-3432
US

V. Phone/Fax

Practice location:
  • Phone: 908-251-9931
  • Fax:
Mailing address:
  • Phone: 908-251-9931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberDEFIN
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: