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General NPI Number Information
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NPI Number | 1790677284
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Entity Type | Individual
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Provider Name | EDWARD MOGERE NYAMWEMBE APN
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Gender | Male
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1767 MANOR DR APT C
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City | IRVINGTON
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State | NJ
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Zip | 07111-1053
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Country | US
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Telephone | 862-576-3598
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Fax |
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Provider Business Mailing Address
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Address Line | 252 COUNTY ROAD 601
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City | BELLE MEAD
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State | NJ
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Zip | 08502-3923
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Country | US
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Telephone | 862-576-3598
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 26NJ15363100
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License Number State | NJ
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