Provider Demographics
NPI:1891822441
Name:DYECHO, ANGELINA D (RN)
Entity Type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:D
Last Name:DYECHO
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 1:16 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1308
Mailing Address - Country:US
Mailing Address - Phone:201-451-7072
Mailing Address - Fax:
Practice Address - Street 1:249 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1423
Practice Address - Country:US
Practice Address - Phone:201-395-5428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08171200163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)