Provider Demographics
NPI:1043453558
Name:BETHESDA NURSING AGENCY
Entity Type:Organization
Organization Name:BETHESDA NURSING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:C
Authorized Official - Last Name:ONWU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-351-1656
Mailing Address - Street 1:104 VERMONT AVE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-2039
Mailing Address - Country:US
Mailing Address - Phone:973-351-1656
Mailing Address - Fax:973-374-5717
Practice Address - Street 1:104 VERMONT AVE
Practice Address - Street 2:FLOOR 1
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-2039
Practice Address - Country:US
Practice Address - Phone:973-351-1656
Practice Address - Fax:973-374-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0125700251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care