Iyana Anderson

Individual provider Active NPI Case Manager/Care Coordinator · Newark, NJ

NPI 1750160990 · NPPES record last updated Sep 27, 2023

Key facts

NPI
1750160990
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
44SL06665900 (NJ)
Practice address
183 S Orange Ave
Newark, NJ 07103-2757
Phone
(973) 972-0480
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
Yes

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
44SL06665900NJMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 44SL06665900 NJ Yes

Addresses

Primary practice location

183 S Orange Ave
Newark, NJ 07103-2757

Mailing address

671 Hoes LN W
Piscataway, NJ 08854-8021

Other providers in Newark, NJ

All providers in Newark, NJ · Case Manager/Care Coordinator in New Jersey

Sources for this page

Verify at the official NPI Registry.