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General NPI Number Information
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NPI Number | 1710855929
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Entity Type | Organization
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Legal Business Name | HERA HEALTH HAVEN LLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 541 CEDAR HILL AVE STE 1, FIRST FLOOR
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City | WYCKOFF
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State | NJ
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Zip | 07481-2150
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Country | US
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Telephone | 201-240-1593
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Fax | 551-269-2313
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Provider Business Mailing Address
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Address Line | 541 CEDAR HILL AVE STE 1, FIRST FLOOR
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City | WYCKOFF
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State | NJ
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Zip | 07481-2150
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Country | US
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Telephone | 201-240-1593
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Fax | 551-269-2313
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | NAGAEDA JEAN
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Credential | MD
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Telephone | 201-240-1593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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