Individual provider · Type 1 NPI

Mavis Camalita Ermakov, R.D., RN., CDE., APN

Family Nurse Practitioner · Newark, NJ

NPI number 1265614911 Active

Practice location

741 Broadway
Newark, NJ 07104-4309

Mailing address

731 Liberty Ct
Piscataway, NJ 08854-7206

Other practice locations

  • 731 Liberty Ct, Piscataway, NJ 08854-7206 · (732) 937-5952

Specialties and licenses

TaxonomyCodeLicense
Registered Dietitian 133V00000X0071705 (IL)
Metabolic Nutrition Registered Dietitian 133VN1006X717052 (ID#) (IL)
Diabetes Educator Registered Nurse 163WD0400X26NR112011600 (NJ)
Family Nurse Practitioner Primary 363LF0000X26NJ00421400 (NJ)

Family Nurse Practitioner: Definition to come...

57 other providers at this address

Other family nurse practitioner providers in Newark

See all in Newark →

About NPI 1265614911

Mavis Camalita Ermakov, R.D., RN., CDE., APN's National Provider Identifier is 1265614911, issued on Dec 4, 2007. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Newark, NJ. The record was last updated on Aug 17, 2021.