Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NJ00957000 | NJ |
NPI | 1013551092 |
---|---|
Provider Name | Maria Abigail Pama |
First Address | Montclair, NJ 07042-2929 |
Second Address | Montclair, NJ 07042-2929 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2019 |
Last Update Date | 01/11/2019 |