Provider Demographics
NPI:1538406707
Name:DIMES, ESTELA P (APN)
Entity type:Individual
Prefix:MRS
First Name:ESTELA
Middle Name:P
Last Name:DIMES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2008
Mailing Address - Country:US
Mailing Address - Phone:732-235-8993
Mailing Address - Fax:732-235-7796
Practice Address - Street 1:317 GEORGE ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2008
Practice Address - Country:US
Practice Address - Phone:732-235-8993
Practice Address - Fax:732-235-7796
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00406000163WC3500X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WC3500XNursing Service ProvidersRegistered NurseCardiac Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ00406000OtherNJ APN LICENSE