Provider Demographics
NPI:1083460273
Name:LIVINGSTON, JHAMELLLIA
Entity type:Individual
Prefix:
First Name:JHAMELLLIA
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08804-3008
Mailing Address - Country:US
Mailing Address - Phone:908-200-5727
Mailing Address - Fax:
Practice Address - Street 1:48 BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:BLOOMSBURY
Practice Address - State:NJ
Practice Address - Zip Code:08804-3008
Practice Address - Country:US
Practice Address - Phone:908-200-5727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker