Provider Demographics
NPI:1487970356
Name:AMONI, ALICE (N URSE)
Entity type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:
Last Name:AMONI
Suffix:
Gender:F
Credentials:N URSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 ALDEN ST
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07050-1903
Mailing Address - Country:US
Mailing Address - Phone:973-432-7285
Mailing Address - Fax:
Practice Address - Street 1:391 ALDEN ST
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07050-1903
Practice Address - Country:US
Practice Address - Phone:973-432-7285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-15
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP06288100164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse