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General NPI Number Information
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NPI Number | 1215655782
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Entity Type | Individual
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Provider Name | PRECIOUS 134-04- NWIGWE
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Gender | Female
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 1042 JOHN GLENN DR
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City | HILLSIDE
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State | NJ
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Zip | 07205-2743
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Country | US
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Telephone | 908-906-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 1042 JOHN GLENN DR
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City | HILLSIDE
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State | NJ
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Zip | 07205-2743
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Country | US
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Telephone | 908-906-3491
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 795333
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License Number State | NY
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