Charity Mantebea

Individual provider Active NPI Home Health Aide · South River, NJ

NPI 1245807932 · NPPES record last updated Jun 9, 2021

Key facts

NPI
1245807932
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
License
GYD5VA (NJ)
Practice address
47 W Grochowiak St
South River, NJ 08882-1539
Phone
(609) 254-7360
NPI assigned
Jun 9, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
GYD5VANJMDHome Health Aide

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X GYD5VA NJ Yes

Addresses

Primary practice location

47 W Grochowiak St
South River, NJ 08882-1539

Mailing address

47 W Grochowiak St
South River, NJ 08882-1539
Phone (609) 254-7360

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Laptop Direct

Other providers in South River, NJ

All providers in South River, NJ · Home Health Aide in New Jersey

Sources for this page

Verify at the official NPI Registry.