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1194354126
TATIANA DEA
BLOOMFIELD, NJ
NPI
1194354126
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NJ 26NJ00957700)
Enumeration Date
2020-04-02
Last Update Date
2020-04-02
Business Address
TATIANA DEA APN
1255 BROAD ST
BLOOMFIELD, NJ 07003-3000
Phone number: 201-833-9500
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Mailing Address
TATIANA DEA APN
310 COPPERFIELD LN
METUCHEN, NJ 08840-1240
Phone number: 240-645-3252
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