Healthcare Provider Details

I. General information

NPI: 1508211541
Provider Name (Legal Business Name): EUNICE ASIEDU YEBOAH CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EUNICE ASIEDU CNM

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 05/23/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TRINITAS REGIONAL MEDICAL CENTER 225 WILLIAMSON STREET
ELIZABETH NJ
07202
US

IV. Provider business mailing address

908 VALLEY ROAD
WATCHUNG NJ
07069
US

V. Phone/Fax

Practice location:
  • Phone: 908-994-5000
  • Fax: 414-906-4533
Mailing address:
  • Phone: 414-249-0416
  • Fax: 404-294-1558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number148908
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN218856
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: