Provider Demographics
NPI:1952448326
Name:ERAZO, MIGDALIA (RN,APN)
Entity Type:Individual
Prefix:MRS
First Name:MIGDALIA
Middle Name:
Last Name:ERAZO
Suffix:
Gender:F
Credentials:RN,APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1920
Mailing Address - Country:US
Mailing Address - Phone:973-763-4370
Mailing Address - Fax:
Practice Address - Street 1:100 BERGEN ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2494
Practice Address - Country:US
Practice Address - Phone:973-819-6210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07919900163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development