Provider Demographics
NPI:1053877837
Name:CONTEH, ETTA
Entity type:Individual
Prefix:
First Name:ETTA
Middle Name:
Last Name:CONTEH
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 1:250 MARLBORO RD
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-1401
Mailing Address - Country:US
Mailing Address - Phone:732-570-8555
Mailing Address - Fax:
Practice Address - Street 1:250 MARLBORO RD
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-1401
Practice Address - Country:US
Practice Address - Phone:732-570-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-16
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist