Intal, Thea De Guzman

Intal, Thea De Guzman is an sole proprietor health care provider with primary practice located at 36 Newark Ave Ste 300 , Belleville NJ 07109-4122. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Intal, Thea De Guzman can be contacted via phone (973) 873-0195.

Contact Information

Primary practice address
36 Newark Ave Ste 300 Belleville NJ 07109-4122
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 26NJ14933100 New Jersey

Profile Details

NPI number 1093596744
LBN Legal business name Intal, Thea De Guzman
Credentials FNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 9th, 2023
Last updated Dec 26th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093596744 NPPES
New Jersey MEDICAID 0960691

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