Provider Demographics
NPI:1790320562
Name:NGUETSOP, ARMAND
Entity Type:Individual
Prefix:
First Name:ARMAND
Middle Name:
Last Name:NGUETSOP
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 1:8 PARK PL
Mailing Address - Street 2:
Mailing Address - City:MIDDLESEX
Mailing Address - State:NJ
Mailing Address - Zip Code:08846-1521
Mailing Address - Country:US
Mailing Address - Phone:908-340-7279
Mailing Address - Fax:
Practice Address - Street 1:8 PARK PL
Practice Address - Street 2:
Practice Address - City:MIDDLESEX
Practice Address - State:NJ
Practice Address - Zip Code:08846-1521
Practice Address - Country:US
Practice Address - Phone:908-340-7279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR16829400163WA2000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2396630OtherSTATE OF NJ BUSINESS CERTIFICATE OF REGISTRATION.