Healthcare Provider Details

I. General information

NPI: 1477283158
Provider Name (Legal Business Name): EDNA LYN CORPUZ-ESCONDE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 MORRISTOWN RD
BASKING RIDGE NJ
07920-1654
US

IV. Provider business mailing address

11 WOODSIDE AVE
LITTLE FALLS NJ
07424-1315
US

V. Phone/Fax

Practice location:
  • Phone: 908-303-9104
  • Fax:
Mailing address:
  • Phone: 973-652-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number26NO10757700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: