Provider Demographics
NPI:1669294450
Name:BROOMES-BROWN, MONIQUE AFIA (NP)
Entity type:Individual
Prefix:MRS
First Name:MONIQUE
Middle Name:AFIA
Last Name:BROOMES-BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ALPHA
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-4513
Mailing Address - Country:US
Mailing Address - Phone:973-495-1896
Mailing Address - Fax:
Practice Address - Street 1:901 2ND AVE
Practice Address - Street 2:
Practice Address - City:ALPHA
Practice Address - State:NJ
Practice Address - Zip Code:08865-4513
Practice Address - Country:US
Practice Address - Phone:973-495-1896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ150580400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily