Provider Demographics
NPI:1194397737
Name:WARD, GERALDINE LINETTE
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:LINETTE
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-1871
Mailing Address - Country:US
Mailing Address - Phone:908-943-8971
Mailing Address - Fax:
Practice Address - Street 1:744 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-3802
Practice Address - Country:US
Practice Address - Phone:201-487-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator