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General NPI Number Information
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NPI Number | 1932095072
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Entity Type | Individual
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Provider Name | AYESHA HARGROVE NP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 741 BROADWAY
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City | NEWARK
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State | NJ
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Zip | 07104-4309
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Country | US
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Telephone | 973-483-1300
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Fax | 973-696-1396
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Provider Business Mailing Address
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Address Line | 16 WILLIAMSON AVE
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City | HILLSIDE
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State | NJ
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Zip | 07205-1606
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Country | US
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Telephone | 973-713-1156
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ15299000
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License Number State | NJ
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