Healthcare Provider Details

I. General information

NPI: 1366249799
Provider Name (Legal Business Name): EDNA ASMAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 GROVE AVE
EDISON NJ
08820-3212
US

IV. Provider business mailing address

7 ALBERT DR
PARLIN NJ
08859-1801
US

V. Phone/Fax

Practice location:
  • Phone: 732-937-3275
  • Fax:
Mailing address:
  • Phone: 732-937-3275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number26NR21099300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: