Provider Demographics
NPI:1275305401
Name:DARMETKO, BRETT
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:DARMETKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-1221
Mailing Address - Country:US
Mailing Address - Phone:973-733-7600
Mailing Address - Fax:
Practice Address - Street 1:394 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-1221
Practice Address - Country:US
Practice Address - Phone:973-733-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ704004163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse