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General NPI Number Information
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NPI Number | 1043453558
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Entity Type | Organization
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Legal Business Name | BETHESDA NURSING AGENCY
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Dates
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Enumeration Date | 04/14/2009
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Last Update Date | 04/14/2009
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Provider Practice Location Address
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Address Line | 104 VERMONT AVE FLOOR 1
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City | NEWARK
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State | NJ
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Zip | 07106-2039
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Country | US
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Telephone | 973-351-1656
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Fax | 973-374-5717
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Provider Business Mailing Address
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Address Line | 104 VERMONT AVE FLOOR 1
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City | NEWARK
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State | NJ
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Zip | 07106-2039
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Country | US
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Telephone | 973-351-1656
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Fax | 973-374-5717
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS ESTHER C ONWU
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Credential | RN
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Telephone | 973-351-1656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HP0125700
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License Number State | NJ
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