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General NPI Number Information
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NPI Number | 1609582741
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Entity Type | Individual
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Provider Name | ADA M ANDINO RN, APN
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Gender | Female
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Dates
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Enumeration Date | 01/23/2023
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 624 NEWARK AVE
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City | ELIZABETH
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State | NJ
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Zip | 07208-3539
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Country | US
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Telephone | 908-353-3626
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Fax | 908-353-3625
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Provider Business Mailing Address
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Address Line | 207 E 9TH ST
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City | PLAINFIELD
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State | NJ
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Zip | 07060-2530
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Country | US
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Telephone | 908-422-2758
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01419100
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License Number State | NJ
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