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Contact Information

PAMELA ANDERSON
354 DOREMUS AVE
NEWARK, NJ07105-4882
 Phone: 973-274-6816
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

163WG0000X
 

Adult Medicine

207QA0505X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for PAMELA ANDERSON · (Female)

NPI Number 1013600162
Status Active
Credentials
Entity Individual
Enumeration date 06/02/2023
Last updated 06/02/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 26NN08240300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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