Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F421532 | NY |
NPI | 1043962152 |
---|---|
Provider Name | Edith Chau |
First Address | Springfield, NJ 07081-3411 |
Second Address | Union, NJ 07083-8317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2022 |
Last Update Date | 26/01/2022 |