Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00011200 | NJ |
NPI | 1003999046 |
---|---|
Provider Name | Cynthia Dayrit -Demetillo |
First Address | Paterson, NJ 07503-2212 |
Second Address | Paterson, NJ 07503-2212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 21/11/2014 |