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Ms. Elena L Wickstrom, MD
Student in an Organized Health Care Education/Training Program in Newark, New Jersey
NPI 1003497470

Elena L Wickstrom is a Student in an Organized Health Care Education/Training Program based in Newark, NJ. Elena L Wickstrom practices in Newark, NJ and has the professional credentials of MD. The NPI Number for Elena L Wickstrom is 1003497470 and holds a License No. (New Jersey).

The current practice location address for Elena L Wickstrom is 185 S Orange Ave, Newark, NJ and can be reached out via phone at 732-445-4636.

Location: 185 S Orange Ave, Newark, NJ, 07103-2757
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003497470
Provider Name
Elena L Wickstrom
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
185 S Orange Ave, Newark, NJ, 07103-2757
Phone Number
732-445-4636
Fax Number
Provider Enumeration Date
04/17/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
185 S Orange Ave
City
Newark
State
New Jersey
Zip
07103-2757
Phone Number
732-445-4636
Fax Number
person
Provider Business Mailing Address Details
Address
185 S Orange Ave
City
Newark
State
New Jersey
Zip
07103-2757
Phone Number
732-445-4636
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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