Provider Demographics
NPI:1285797985
Name:EZE, EDITH N (CNM)
Entity type:Individual
Prefix:
First Name:EDITH
Middle Name:N
Last Name:EZE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WECK CT
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-2145
Mailing Address - Country:US
Mailing Address - Phone:732-257-5066
Mailing Address - Fax:
Practice Address - Street 1:444 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-2213
Practice Address - Country:US
Practice Address - Phone:973-675-1900
Practice Address - Fax:973-675-4021
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO08947000163W00000X
NJ25ME00038900176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1063683258Other751 BROADWAY
NJ1235300799Other37 N DAY
NJ1740345693Other741 BROADWAY
NJ84468Medicaid
NJ1194996645Other444 WILLIAM STREET
NJ1548431091Other982 BROAD STREET
NJ1932370483Other101 LUDLOW STREET
NJ1972778413Other1150 SPRINGFIELD AVE
NJ222747589OtherNCHC EIN