Provider Demographics
NPI:1508614777
Name:NGOUFACK-TIOGUEM, AURELIE (RN)
Entity Type:Individual
Prefix:
First Name:AURELIE
Middle Name:
Last Name:NGOUFACK-TIOGUEM
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 1:319 DUNELLEN AVE
Mailing Address - Street 2:
Mailing Address - City:DUNELLEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1233
Mailing Address - Country:US
Mailing Address - Phone:908-247-4230
Mailing Address - Fax:
Practice Address - Street 1:901 FRONTIER RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2936
Practice Address - Country:US
Practice Address - Phone:732-507-5151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-10
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18545900163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse