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Ms. Kempolly Datisha Swaby
Gerontology Nurse Practitioner in Orange, New Jersey
NPI 1750056495

Kempolly Datisha Swaby is a Gerontology Nurse Practitioner based in Orange, NJ and is specialized in Gerontology. Kempolly Datisha Swaby practices in Orange, NJ. The NPI Number for Kempolly Datisha Swaby is 1750056495 and holds a License No. 26NJ01183500 (New Jersey).

The current practice location address for Kempolly Datisha Swaby is 531 Lincoln Ave, Orange, NJ and can be reached out via phone at 973-941-6617.

Location: 531 Lincoln Ave, Orange, NJ, 07050-2122
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750056495
Provider Name
Kempolly Datisha Swaby
Credential
Provider Entity Type
Individual
Gender
Female
Address
531 Lincoln Ave, Orange, NJ, 07050-2122
Phone Number
973-941-6617
Fax Number
Provider Enumeration Date
08/13/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
531 Lincoln Ave
City
Orange
State
New Jersey
Zip
07050-2122
Phone Number
973-941-6617
Fax Number
person
Provider Business Mailing Address Details
Address
531 Lincoln Ave
City
Orange
State
New Jersey
Zip
07050-2122
Phone Number
973-941-6617
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
26NJ01183500 (New Jersey)
Definition
Definition to come...
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