Healthcare Provider Details

I. General information

NPI: 1285797985
Provider Name (Legal Business Name): EDITH N EZE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 WILLIAM ST
EAST ORANGE NJ
07017-2213
US

IV. Provider business mailing address

2 WECK CT
SAYREVILLE NJ
08872-2145
US

V. Phone/Fax

Practice location:
  • Phone: 973-675-1900
  • Fax: 973-675-4021
Mailing address:
  • Phone: 732-257-5066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NO08947000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number25ME00038900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: