NPI 1003497470

Elena L Wickstrom, MD

Practitioner Student in an Organized Health Care Education/Training Program Newark, NJ

Practice location

Address: 185 S Orange Ave, Newark, NJ 07103-2757
Phone: (732) 445-4636

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003497470
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Apr 2021
Record last updated: 28 Mar 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.