Guimary, Imelda De Vera

Guimary, Imelda De Vera is an sole proprietor health care provider with primary practice located at 268 Martin Luther King Jr Blvd , Newark NJ 07102-2011. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Guimary, Imelda De Vera can be contacted via phone (201) 512-9494.

Contact Information

Primary practice address
268 Martin Luther King Jr Blvd Newark NJ 07102-2011
Phone: (201) 512-9494
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X NJ000899 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 26NJ0008990 New Jersey

Profile Details

NPI number 1073687760
LBN Legal business name Guimary, Imelda De Vera
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 17th, 2006
Last updated Nov 10th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073687760 NPPES
New Jersey MEDICAID 221775306
New Jersey MEDICAID 6301703

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