Provider Demographics
NPI:1356603344
Name:KWIMI, ALBERT (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:KWIMI
Suffix:
Gender:M
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WOODFIELD RD
Mailing Address - Street 2:
Mailing Address - City:GREEN TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07821-2001
Mailing Address - Country:US
Mailing Address - Phone:240-421-5451
Mailing Address - Fax:
Practice Address - Street 1:22 WOODFIELD RD
Practice Address - Street 2:
Practice Address - City:GREEN TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07821-2001
Practice Address - Country:US
Practice Address - Phone:240-421-5451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15034600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health