Hermina Antwi-Boasiako, NP-C

Individual provider Active NPI Family Nurse Practitioner · Old Bridge, NJ

NPI 1780933812 · NPPES record last updated Feb 24, 2017

Key facts

NPI
1780933812
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
26NJ00392000 (NJ)
Practice address
2988 Route 516
Old Bridge, NJ 08857-2325
Phone
(866) 389-2727
NPI assigned
Sep 5, 2012
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)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ00392000NJMDFamily Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NJ00392000 NJ Yes

Addresses

Primary practice location

2988 Route 516
Old Bridge, NJ 08857-2325

Mailing address

2988 Route 516
Old Bridge, NJ 08857-2325
Phone (866) 389-2727

Other providers in Old Bridge, NJ

All providers in Old Bridge, NJ · Family Nurse Practitioner in New Jersey

Sources for this page

Verify at the official NPI Registry.