Healthcare Provider Details

I. General information

NPI: 1073341046
Provider Name (Legal Business Name): ESTHER GEWIRTZMAN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 WARNER ST # 1028
TOMS RIVER NJ
08755-1028
US

IV. Provider business mailing address

5 KING DAVID DR
LAKEWOOD NJ
08701-4634
US

V. Phone/Fax

Practice location:
  • Phone: 973-494-6262
  • Fax:
Mailing address:
  • Phone: 973-494-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ15101700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: