Provider Demographics
NPI:1083209480
Name:VINING, ALREEMA (CD)
Entity Type:Individual
Prefix:
First Name:ALREEMA
Middle Name:
Last Name:VINING
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:DOULA ALREEMA
Other - Middle Name:
Other - Last Name:VINING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CD
Mailing Address - Street 1:PO BOX 1313
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07101-1313
Mailing Address - Country:US
Mailing Address - Phone:862-622-3142
Mailing Address - Fax:
Practice Address - Street 1:2 CUSTER AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2542
Practice Address - Country:US
Practice Address - Phone:862-622-3142
Practice Address - Fax:973-556-1936
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-08
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide
No174H00000XOther Service ProvidersHealth Educator
No174N00000XOther Service ProvidersLactation Consultant, Non-RN
No175T00000XOther Service ProvidersPeer Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0771538Medicaid