Healthcare Provider Details

I. General information

NPI: 1518832773
Provider Name (Legal Business Name): EDLIRA BREGU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 LYONS AVE
NEWARK NJ
07112-3586
US

IV. Provider business mailing address

102 SERPENTINE DR
MORGANVILLE NJ
07751-1400
US

V. Phone/Fax

Practice location:
  • Phone: 973-926-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number26NJ15418600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: