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General NPI Number Information
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NPI Number | 1811704596
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Entity Type | Individual
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Provider Name | DIVINE G ABREU FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1738 ROUTE 31 NORTH SUITE #203
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City | CLINTON
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State | NJ
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Zip | 08809
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Country | US
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Telephone | 908-735-4645
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Fax |
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Provider Business Mailing Address
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Address Line | 44 YOUMANS AVE
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City | WASHINGTON
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State | NJ
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Zip | 07882-1848
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Country | US
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Telephone | 908-894-3783
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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 | 26NJ15198100
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License Number State | NJ
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