Healthcare Provider Details
I. General information
NPI: 1285803403
Provider Name (Legal Business Name): BARBARA PODINKER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/21/2008
Last Update Date: 12/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 WASHINGTON ST
NEWARK NJ
07102-3026
US
IV. Provider business mailing address
151 WASHINGTON ST
NEWARK NJ
07102-3026
US
V. Phone/Fax
- Phone: 973-622-3900
- Fax: 973-622-1698
- Phone: 973-622-3900
- Fax: 973-622-1698
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 26NJ00145000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: