Provider Demographics
NPI:1902611908
Name:YAREMKO, MARY ELLEN (RN)
Entity type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:
Last Name:YAREMKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 STADTMAUER DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2512
Mailing Address - Country:US
Mailing Address - Phone:973-214-5866
Mailing Address - Fax:
Practice Address - Street 1:79 STADTMAUER DR
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2512
Practice Address - Country:US
Practice Address - Phone:973-214-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-08
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO06135200163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency