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1750056495
KEMPOLLY DATISHA SWABY
ORANGE, NJ
NPI
1750056495
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: NJ 26nj01183500)
Enumeration Date
2021-08-13
Last Update Date
2021-08-17
Business Address
Ms. KEMPOLLY DATISHA SWABY
531 LINCOLN AVE
ORANGE, NJ 07050-2122
Phone number: 973-941-6617
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Mailing Address
Ms. KEMPOLLY DATISHA SWABY
531 LINCOLN AVE
ORANGE, NJ 07050-2122
Phone number: 973-941-6617
Copy
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