| Provider / Organization | NPI | Date Certified |
|---|---|---|
| IMELDA DE VERA GUIMARY | 1073687760 | 2023-11-10 |
Imelda De Vera Guimary is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1073687760. Registration indicates Imelda De Vera Guimary is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse, ) (All Other Specialties & Provider Types, ) (Registered Nurse, Nursing Service Providers) Access to Adult/Geriatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers)
| Entity Type | Individual |
| Provider Name | Mrs. Imelda De Vera Guimary NP |
| Practice Office Address | 268 MARTIN LUTHER KING JR BLVD NEWARK, NJ US |
| Practice Office Telephone | 2015129494 |
| Mailing Address | 120 HILLSIDE AVE NUTLEY, NJ 071101600 US |
| Business Telephone | 8625964300 |
| Code | Practice | License No State |
|---|---|---|
| 163W00000X | Nursing Service Providers Registered Nurse Registered Nurse All Other Specialties & Provider Types Registered Nurse Nursing Service Providers | NJ000899
NJ |
| 363L00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner All Other Specialties & Provider Types Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers | 26NJ0008990
NJ |
| 221775306 | MEDICAID | NJ | |
| 6301703 | MEDICAID | NJ |