Healthcare Provider Details

I. General information

NPI: 1013809235
Provider Name (Legal Business Name): ROBERT MICHAEL WALDMAN RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 BERGEN ST
NEWARK NJ
07107-3001
US

IV. Provider business mailing address

65 BERGEN ST
NEWARK NJ
07107-3001
US

V. Phone/Fax

Practice location:
  • Phone: 973-353-5293
  • Fax:
Mailing address:
  • Phone: 973-353-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number788961
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number788961-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: