GEORGETTE WILSON-GRANBY

NEWARK, NJ
NPI1548311434
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: NJ  26NN07778700)
Additional Taxonomies363LA2200X Nurse Practitioner, Adult Health
(Licence: NY  302415)
Enumeration Date2007-01-16
Last Update Date2007-07-08
Business Address
-- GEORGETTE WILSON-GRANBY
111 CENTRAL AVE SMMC, EMPLOYEE HEALTH - MSH ROOM 203
NEWARK, NJ 07102-1909
Phone number: 973-877-5452
Mailing Address
-- GEORGETTE WILSON-GRANBY
3204 HANA RD
EDISON, NJ 08817-2552
Phone number: 972-877-5452