Provider Demographics
NPI:1578866711
Name:WAREDA, MAGDALENA ANNA (RN)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:ANNA
Last Name:WAREDA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 E PRICE ST
Mailing Address - Street 2:1 FLOOR
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-2829
Mailing Address - Country:US
Mailing Address - Phone:908-494-8902
Mailing Address - Fax:908-925-1162
Practice Address - Street 1:506 E PRICE ST
Practice Address - Street 2:1 FLOOR
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-2829
Practice Address - Country:US
Practice Address - Phone:908-494-8902
Practice Address - Fax:908-925-1162
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY637914-1163W00000X
NJ26 NR14919800163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse