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General NPI Number Information
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NPI Number | 1720344351
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Entity Type | Organization
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Legal Business Name | NURSE PRACTITIONER PROFESSIONAL SERVICES INC
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 100 WEST MAGNOLIA AVENUE MAYWOOD CENTER FOR HEALTH & REHABILITATION
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City | MAYWOOD
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State | NJ
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Zip | 07607
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Country | US
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Telephone | 201-373-8300
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Fax |
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Provider Business Mailing Address
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Address Line | 350 RAMAPO VALLEY RD SUITE # 18 -284
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City | OAKLAND
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State | NJ
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Zip | 07436-2702
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Country | US
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Telephone | 646-239-1927
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KAREN A. HIBBERT-OZUZU
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Credential | ANP,BC
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Telephone | 646-239-1927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00088900
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License Number State | NJ
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