| NPI | 1568974418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAVIS CAMALITA FAULKNOR CEO/Social Entrepreneur 201-618-1472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00421400) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered Nutrition, Metabolic (Licence: IL 0071705) |
| 163WD0400X Registered Nurse Diabetes Educator (Licence: NJ 26NR11201600) | |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2017-11-01 |