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General NPI Number Information
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NPI Number | 1912000712
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Entity Type | Individual
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Provider Name | REETU MALINI SOOKRAJ APRN, BC
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Gender | Female
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 111 CENTRAL AVE CARDIAC CATH LAB
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City | NEWARK
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State | NJ
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Zip | 07102-1909
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Country | US
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Telephone | 973-877-5153
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Fax | 973-877-2904
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Provider Business Mailing Address
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Address Line | 286 LAUREL AVE
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City | KEARNY
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State | NJ
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Zip | 07032-3634
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Country | US
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Telephone | 201-998-3186
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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 | 26NJ00015200
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License Number State | NJ
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