Healthcare Provider Details

I. General information

NPI: 1174157069
Provider Name (Legal Business Name): PEARLENA DEAN-RAMSAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2020
Last Update Date: 02/28/2020
Certification Date: 02/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 E 3RD ST
PLAINFIELD NJ
07060-1408
US

IV. Provider business mailing address

628 E 3RD ST
PLAINFIELD NJ
07060-1408
US

V. Phone/Fax

Practice location:
  • Phone: 908-561-1430
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ00951300
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: