Gifty Boaten

Individual provider Active NPI Licensed Practical Nurse · Avenel, NJ

NPI 1831556448 · NPPES record last updated Jan 27, 2016

Key facts

NPI
1831556448
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
307198 (NY)
Practice address
3505 Village Dr
Avenel, NJ 07001-1064
Phone
(917) 407-3447
NPI assigned
Jan 27, 2016
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 307198 NY Yes

Addresses

Primary practice location

3505 Village Dr
Avenel, NJ 07001-1064

Mailing address

3505 Village Drive
Avenel, NJ 07001
Phone (917) 407-3447

Other providers in Avenel, NJ

All providers in Avenel, NJ · Licensed Practical Nurse in New Jersey

Sources for this page

Verify at the official NPI Registry.